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EVERETI, WASH. <br />The Undersigned <br />Approved By <br />TI ST, G}4U jeC,f-} Date Approved <br />d <br />t <br />Hereby applies for permission to INS TALL PR V e WADI <br />At the following location_ CR:51 N (3 4:y/a 15 Ic- <br />SKETCH I 1 <br />(Work to be done) <br />1;ne <br />RA, <br />A,5P,,q a L 7- <br />PAVING <br />CH Urz^H <br />1 <br />C.4sr No RA <br />/NSrl9LL <br />4 <br />The undersigned owner hereby agrees to hold and save harmless the City of <br />Everett from any and all -.laims for damages that may arise because of the <br />installation and maintenome of the improvement hereto applied for and <br />further agrees to remove son a upon notice from the City and to replace all <br />public property damaged rhere,,y. <br />DRIVEWAY SECTION <br />NO SOLLE <br />i <br />I" LIP <br />impectoi s Signature <br />,5� c_�ir/I�CK2l1 /O <br />Date <br />Call Engineering Deft. 25:i oji <br />24 Hours before <br />1ontruclioll is U <br />lbw <br />I'—' h n ' <br />//2" Cu1-ase <br />C'Is/wo AC D. <br />Varian. a Required <br />Yes_.................... <br />No_._.................... <br />iA ign6Wre of Applicant <br />oc73¢ c--n/ ,' Address <br />�vElP,eij G. !�J/l% <br />�1 Telephone Number <br />UDC lei —/7— 7e—, <br />Date <br />Tes <br />NOTE <br />CI!`rK 'PlITFi vJR1, 11 <br />ATION <br />CC A Is — <br />DEPT. APPRQVA <br />Engineer— i/LILC¢ <br />Water 4`]< ' 7' /C' %F - 7 4- <br />Street <br />Communi . calgruf '�'•��- _ 1r i.. . <br />Traffic. ' <br />Planning L' <br />PROVIDE fOR <br />PROPER DRAINAGE <br />.�. <br />wo <br />