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ev,Iell <br />CITY ENGINEERS <br />EVERETT, WASHINGTON <br />The Undersigned <br />Hereby applies fo <br />At the following location <br />SKETCH <br />(Work to be done) <br />ORIVFWAY SECTION <br />NO SCALE <br />_ jl'LIP <br />301, <br />COPY OF THIS APPLICATION TO <br />BE POSTED ON JOBSITE. <br />CALL ENGINEERING DEPT. 259-8811 <br />24 HOURS BEFORE CONSTRUCTION <br />CHECK LIST <br />Water Valve <br />Drainage <br />Curb & Gutter <br />Sidewalk <br />Inspector's Signature <br />Date <br />Remarks <br />Note: Original to Customer i Copy ii, i iie 1.091A <br />1 Copy to Inspvctor <br />10,,1 r . <br />PERMITNO. <br />The undersigned owner hereby agrees to hold and <br />save harmless the City of Everett from any and all <br />claims for damages that may arise because of installa• <br />tion and maintenance of the improvement hereto <br />applied for and further agrees to remove same upon <br />do—tRa,from the City and to replace public property <br />36-� -770D <br />Telephone Numb r <br />7,/ 7% <br />Date. <br />/ 7 � <br />Fee <br />Dept. /Approvals <br />sn <br />Engineers ?1L/^-•'-1 <br />Communica <br />Approved by <br />Date Ailwovvd <br />