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CITY ENGINEERS /�.3. �
<br /> E\.'ERETT,WASHINGTON PERhtIT N0. % ��
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<br /> � The Undersi�ned__L� �-�i� S�/�L/N
<br /> Hemby applios f�r permission�;o��U il/S?��+Gs '2 -� /� � �a�.'Yif:�rr. " i� ��.�� �c
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<br /> � DRIVEWAY SECTION q - Tt�e undersigned owner hereby agrees to hold and
<br /> NO SCaLE save harmless the City of Everet[from any and all �
<br /> �- —�—"j claims for damages ihat may arise because of installa�
<br /> �C__�_� L�P � [ion and maintenance of the improvement hereto ',
<br /> applied for and further agrees to rernove same upon �
<br /> . �30" _ �30" notice from he Ci a to r �lac�!pu6 ' roperty ,
<br /> dama,e h9�eb '�
<br /> �
<br /> ' Signa re of Applica � �
<br /> �� � TM �.C-_yt.
<br /> � COPY Of- TH IS APPLICATION T� Addresf ��{� ,, � ��
<br /> � BE POSTFD ON JOBSITE. � r�� I I
<br /> Telepbone Numher ' ��
<br /> CALL ENGINEERNG D'cPT. 259-8811 h <�� '',
<br /> Date �^ � 'y --- '.
<br /> � � 2�1 HOURS B6FORE CUNSTRUCTION � ���
<br /> I CHECK LIST � --T— u' � � f �� �' �I
<br /> J i Fee C�
<br /> ' Wacar vaive ��j ' � Dept. Approvals �
<br /> , Drainage ��,W''(t � � .�� �i' �/, I
<br /> Curb&Gutter I��/�5 Enpineers � .G�i�; ✓=y �
<br /> Sidewalk °0 ���� 7 � ' / � �
<br /> � �
<br /> l Water��,..-c� �/, iY� �1�i� , .6: _'TM-�, i
<br /> Street � '� �
<br /> Communica[ions - I
<br /> , Inspector's Signatur_ �
<br /> i Traffic �
<br /> ''�, Planning '�
<br /> � - at�e — s v ,4,�-��-n ���-. �ia.�=____-, ./<��� i
<br /> �- ,�
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<br /> Remarks — I
<br /> � Note: Original to Customer �
<br /> , �o�Y ta F��e 10 815 — '
<br /> � 1 Copy to Inspector Approved by �
<br /> Date Approved I
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