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CITY ENGINEERS <br />EVERETT, WASH INNG�'T�O,�1UN�+� <br />The Undersigned 'l t—hel e •K R�L� \ <br />Hereby applies for permission to \`S PI-1 fls L=Z ?^V 1 � <br />At the following location/\/ <br />SKETCH <br />(Work to be done) <br />`� <br />(�n�v <br />DRIVEWAY SECTION <br />NO SCALE J <br />' 3 I" LIP <br />1 301, <br />rCOPY OF THIS APPLICATION TO <br />BE POSTED ON JOBSITE. <br />CALL ENGINEERING DEPT.259-8811 <br />[24 HOURS BEFORE CONSTRUCTION <br />4-;i(0 - 7 (::; <br />Date <br />`!` 4 <br />K <br />,;�- /6 t' <br />P� l <br />/ The undersigneAwner hereby agrees to hold and <br />r save harmless the City of Everett from any and all <br />{, c aims for damages that may arise because of installa. <br />�U �/� ton and maintenance of the improvement hereto <br />�� a plied for and further agreLove same upon <br />„ \ n rice from the City an tou I"d r perry <br />d ged thereby. <br />i tur of App i an <br />6� , <br />Qi/ Ad••'ls '� I I It'l <br />4 16 i-- -, I <br />Date <br />-�3 - -Z e+ <br />Fee <br />Re narks <br />Note: Original to Customer <br />1Copy toFile 10365 <br />1 Copy to Inspector Approved by % <br />(Ly �' S <br />Date Appr,8 <br />