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_ qrP �c o RIGHT-OFWAY SE PERMIT �2 5 6
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<br /> CITY EfdGINC-ENS 70
<br /> EVERETT, Wq5FiINGTON PERMITNO. f 7�
<br /> The Undersigned �-' •�-- •�4r-i�c- � �> >y p���� L,l._7�1����- -
<br /> Hereby apPlicc fnr permission to _ G C A `� -:T�'� . 1 - Q. �> T- T G Cr-%c�• �i�U
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<br /> At the following Iceation
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<br /> SICETCN � 1 F � R
<br /> (lVork to be done� �1��� . ��` �;
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<br /> fiRIVEWAY SECTI�� N. "'t A� �' �•�� »'��r� :-�,:.. �•���• The undersi�ned owner hereby ayrees to hold and
<br /> No SCaLE save harmless the Ciry of Everett irom any and atl
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<br /> claims for damages that may arise because of insWtla-
<br /> �.__L' Lla tion and maintenance ot the improvement hereto
<br /> � applied for and turther a9rees to remove same upon
<br /> I 'So" i T __,j_3o" I notice from the Ciry and to replxe public property
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<br /> damaged the eby.
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<br /> Si�nature of A plican
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<br /> � COPY C� �"I� ;�PPLIi;;,TlO."1 TO ll Address ' ..
<br /> � 9E PUSTEU O'd JOuSITE. �`' � � �V�����
<br /> Tclephone Number
<br /> �ICALIENGI':EERI'vGDEPT. 259-8871 "" :y��, \"?_ ,j_\'\'��
<br /> � 2A HOURS 5:FOFl� CONSTRUCTION �ai�
<br /> CHECY, LIST � Fee
<br /> Water Valve Dept. Approvals
<br /> Drainaye
<br /> Cwb&Gutt^_r Engineers
<br /> Sidewalk
<br /> .� . Water
<br /> Street_
<br /> Communications__
<br /> Inspecto.'s Signature
<br /> Traffic
<br /> Planning_
<br /> -Uatc
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<br /> flemarks ,� ,� ,-, � `� --
<br /> � � .. Approverl by
<br /> � CUSTOM[se Dale Appro�ed 4
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