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EVERETT, GNASH. <br />Approved By <br />The Undersigned ^ o L iJ E i� Date Approved <br />Hereby applies for permission to (20/U67-- A STANDARD 0 17.E 5/Mj <br />At the following location L N%Ajol <br />SKETCH coI <br />(Work to be done) B E V E R L Y L A ME <br />00 <br />The undersigned owner hereby agrees to hold and save harmless the City 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 some upon notice from the City and to replace all <br />public property damaged thereby. <br />Inspector's Signature <br />Date <br />PROVIDE FOR <br />PROPER DRAINAGE <br />I <br />No -re, <br />Variance Required <br />gf/0^1 <br />PIJ4 el N 6. Signature of Applicant <br />Address <br />3L90 Y <br />Telephone Number <br />Date <br />KID F E F— <br />Fee <br />DEPT. APPROVALS <br />Engineer' <br />T. 17/ <br />/I- 1- <br />Wafer.�t=.eL. _ <br />Street _ <br />Communications T-" 4- _ 7/ -- <br />Traffic_ f / <br />Planning R11 SS <br />+ NO`f'E Call Engineering Dept. 2594003 <br />CHECK V/ITH WATER 24 Hours Mott <br />,construction FOR WATER LINE Construction is St <br />IOCATJONS BEFORE EXCAVAT10M <br />\J <br />