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- �,��,� ,�� API'UCATiON FOH RIGIIT OP•W�.`I USe r�nMir <br /> . �. , <br /> � ' ,, /_ (��..' <br /> � , <br /> CITY FNGItJf CHS ,!�v'��'r ~ -`. <br /> CVGH[;T, Wnsiil;�GTON PI:RMIT NO.(�`_�_ <br /> Thr. Undersipned_--.----- -. <br /> HcieLy af�Plics for permissinn �r, � . —'--- <br /> Al the foilowing lucation - � . . .. . --- <br /> SK[TCH — <br /> (Work to tx do��e) '� �� � � � �/ :�� 1 ! i�� l�J�/% / ' � — <br /> � � G�.% <br /> i <br /> DRIVEWAY SECTION The undersipneJ owner hereby a9rees to hold and <br /> NO SCALE savr har;nless Ihc City o( [vcrett Irom any anA all <br /> �`----- --' -.i <br /> eieims tur damages that may anse bveause of installa� <br /> � f' I.iP ____�1 �ion and maintenancc of the improvement hcreto <br /> �30" ' �—_ _.--. ._ -- j-30^� I�PnNrd lo� ➢i�d tut�hrr u�reec in rnmGv^srm"up�o� <br /> . ..�--- �- -�---- --��---�"- •'1' nNice from the Cily and to replace public property <br /> demaged therebY.�� � , <br /> ` ' i , - �/ <br /> Siunaturn�ol Applicant —' <br /> , „ <br /> ---_._ ...-- --- . — ._ ' ,_.•� . � . � r. <br /> C(�PYOf 1H15l.fPIICATION70 lAddrcss <br /> [�k POSTCD ON J(.�I3:ITE � . , • ' <br /> CAI.L FNGIN[FRING b[PT. 7�9li911 Telephone Numlmr <br /> 2A HOl1RS [t[fORF CONSTf2UCTION Datv� ' <br /> CH[CK LIST Fee — <br /> Wator Valve - <br /> Draina�e Dept. AppfOVa15 <br /> Cmb R Guttcr Enginccrs_ <br /> Sidewalk <br /> Watcr <br /> � ' Ii Strect <br /> '��v . <br /> Insj • al Si�n,ni�ie� Communications <br /> Trntiic <br /> � � CJ C_-� _� c, -� . , Pienninp -- - <br /> -6ato - — -- — <br /> Nemmkt —'---- _1 i� -- <br /> -- --�. <br /> Appinvad h^_� � j� �'_ <br /> � i ' LL . � . <br /> rur.i„�mi� �~�`— �y <br /> U�la/lppiovrcl �•� /7 e <br />