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The Undersigned <br /> Hereby applies for permission to r �c-m r T a9 1�� f}.5��1FIL� �/„c/ �'n/ C/�� P O� � <br /> _ � V� $L/_'}GR,'TdP �Q�`QA/ Cu4/a-2 AR �.-'1 DnI _ �'f�l/;•#T� P(�Af� <br /> At the following location_,��7- ; F v`iPCrt'�,y/t� � ��✓ I <br /> SKETCH <br /> (Work to be done) <br /> FV`cJ�C�11���� .1:`:� ' � __�..:_._�_._ <br /> I <br /> �7 • .. � ,EX+S>/r/G <br /> ��`�I -- ---____ .. .----- _ .__......._.._-- --------__._�- ----� ---7 i i <br /> • �i S�� i 1� 40 .____ .. _.—__.._.--'- ��iP�7E LJr'�•: <br /> .,,.;. r �-r;zaaos�� �,�,—�y <br /> , , <br /> _. ci:_.��j � ?�IACt�=(oQ �1RS'1� �� <br /> • � .� ^ <br /> W� S � <br /> VJ <br /> _ �� <br /> ,` <br /> � , <br /> ...__.. Q�g2 � �UFiCriZ� F�'� <br /> � _ _-- -- - -• ! '. '�, <br /> SU f�Sfi"� _ � i �_ __ �'t(';I 1'J"s•, <br /> , �-�.,,;���j <br /> �� <br /> i <br /> DRIVEWAY SEC710N�`_.—.------� -�----� � � - �--�� -�-! The undersigned owner hereby agrees to hold and <br /> NO SCALE save harmless the City of Everett from any and all <br /> f.-- --� claims for damages tha[may arise because of installa- <br /> +�„ ��P J� tion and maintenance of the improvement hereto <br /> � applied for and further agrees to remove same upon <br /> 30';,�„ I_30"_ I no 'c ro the City and to replace pu6lic property <br /> J r �p; , � d maged the e /��/f � � <br /> %lii� �V1� � �-- � � X.c.e,"t.�,Q <br /> Signatu pp m r�t <br /> 53 zl �'� � • � 1�4 <br /> COPY OF THIS APPLICATION TO A ress � S- <br /> BE POSTED ON JOBSITE. 35�3��JZ QH <br /> � Telephone Number ,�,/ <br /> : CAi.L EDIG�A7�ERNG DEPT. 253�88 i i �— %7— °7)( <br /> I 24 HOURS BEFORE CONSTRUCTION Date <br /> CHECKLIST Fee �2s� <br /> Wator Valve Dept. Approvals <br /> Drainage <br /> Curb&Gutter En9ineers <br /> Sidewalk Water . <br /> Stree[ <br /> Cnmmunica[ions <br /> Inspector's Signature . Traffic <br /> Planning <br /> a[e <br /> Remarks ����r� <br /> G <br /> Approved by <br /> cU�STOMER Date Approved 3 <br />