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EVE <br />Thc Undcrsigned � rl � rf �;��'i � <br />Herebyappliestorpermissionto (oN�TR�c7' /-I 2S� �,�n/C�:��'�£'�I>/�•J _ <br />At the following locatian�_ �� A'l-'.�"<,���J ��%-_ . <br />(Work to be donc) <br />p,� t� <br />DRIVEWAY SECTION <br />Sc � AT'TA�N EJ <br />�� <br />G•o%la.� �Ur� ��.,rt� <br />✓ !� <br />? <br />:�i.' � <br />NO SCALE�..�.J <br />� I <br />1" I.IP <br />L30'� _ I _30" <br />CCPY OF THIS APPLICATION TO <br />BE POSTtD ON JOBSITE. <br />CALL E-NGINEERING DEPT. 259�8811 <br />24 HOURS BE�ORE CONSTRUCTION <br />CHECK LIST <br />Wator Valve <br />Drain. ye <br />Curb & Gutter <br />Sidewalk <br />Inspector's Signature <br />Remarks <br />Notc: Ori9inal ro Customer <br />i Copy to Pilc 1 ����. � <br />1 CoPy yo In�P�ctor . • <br />The undersigned owner hereby agrees to ho�d znd <br />save harmlzss the Ci:y of Everett from any anC all <br />claims for damages [hat may arise because of instal�a• <br />tion and maintenance of the improvement hereto <br />applied tor and further agrees to remove same upon <br />notice frorp-�he Ciry and toleplace public pro�erty <br />Date <br />Dept. Approvals <br />Communications <br />Traffic <br />/:ppruecd hy <br />Date Appioved <br />