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EVERETT, WASH. <br />Approved By <br />The Undersigned n1 4.. <br />C= i?i1y>f�/13 Date Approved <br />Hereby applies for permission to iWIZIEW t�/l�t���, ✓� r' TU T LrIfST b/ <br />-?257 , nice �.U57 #Z/- iL/7 S7,9N0A2D 5�Z. j <br />2 <br />At the following location 3 9:1 X1-A0/sv4/ <br />SKETCH <br />(Work to be done) <br />BEVERL.Y LANE <br />tverett from any and all claims for damages that may arise because of the <br />Yes., ....... — . ..... ........ <br />installation and maintenance of the improvement hereto applied for and No ..................__...... <br />further agrees to remove sane upon notice from the City and to replace all <br />public property damaged thereby. <br />Inspector's Signature <br />Date <br />Call Engineering Dept. 259.8803 <br />24 Hours before <br />construction is started. <br />` NOTE <br />CHECK WITH WATER <br />DEPT. FOR WATER LINE <br />i LOCATIONS BEFORE EXCAVATION <br />Signature of A plicont U <br />ail�r__�•="�_� r•. � <br />Address <br />/r <br />Telephone Number <br />Dale <br />$ <br />I <br />PROVIDE FOR <br />P!:C; ER DRAINAGE <br />Fee <br />