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Hereby applies for permission to CO A157, S <br />_ s4::i <br />At the following location 310) (�e7 S. <br />SKETCH <br />(Work to be done]� <br />Ir <br />0,1 <br />QJ <br />CAP <br />I v� <br />a <br />4CE <br />'IPRRF <br />i <br />The undersigned owner hereby agrees to hold and save harmless the Lity of <br />Everett from any and all claims for damages that may arise because of the <br />installation and maintenance of the improvement hereto applied for and <br />further agrees to remove same upon notice from the City and to replace all <br />public property damaged thereby. <br />DRIVEWAY SECTION <br />NO 4CALE <br />+ILIP <br />Inspector's ignatuie——T I <br />Date <br />Call Engineering Dept. 259 881I <br />24 Hours be rp <br />construction is <br />,'A <br />JZfaA <br />$. 13.n�tarvfl� <br />NOTE <br />CHECK WITH WATER <br />DEPT. FOR WATER LINE <br />LOCATIONS BEFORE EXCAVATION <br />I.huTIPG <br />Variance Required <br />Yes. _--- ................... <br />No........................ <br />Signature of Applicant <br />Address c /�� r 4 <br />Telephone Number <br />ii <br />Date <br />A efw u <br />QM s-zg Fee <br />Engineers„ <br />Water <br />Street <br />Communications - <br />Planning <br />PROVIDE FOR <br />PROPER DRAINAGE <br />