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;r'y evcren <br />r. � <br />�ITY�ENGINEE.RS <br />�e V E R ETT, �NASH I N GTON <br />I <br />.APYLICA�IUN '-UH HIGHT-UF•WAY USE PfR�AIT 11113 <br />� � <br />�� PEflMIT NO. %�, � ?.�_ <br />The Undersigned _��_�� _�o n r��7 n n Pti <br />i <br />Hcreby applies for permission xo _ fe �, t �' �.=r� .2 �� (o,-� � ,� �� ,�. �' ,�T�,- � �r �� <br />r. .iL/ •'= / � <br />At the following Iceation �o O 2.i �� N U � _n �i q iQ v P _ <br />(Work to be done) <br />DRIVEWAV SECTION <br />NO SCALE <br />I'--_ �.� ' �i <br />� I" LIP � <br />Y'��------ . ....--T��-�1 <br />COPY OF THIS APPLIC.4TI�N 70 <br />BE POSTED ON JOBSITE. <br />CALL ENGINEERING DEFT.259�8811 <br />24 HOUP,S 9EFORE CONSTRUC:TION <br />CHECK LIST <br />Watar Vaive <br />Drainage <br />Curb & Guttei <br />Sidewalk <br />Inspector's Signature <br />Remarks <br />11113 <br />/;�: <br />cuaro� <br />Th� undersigned owner hereby agrees to hold and <br />save harmless the City of Everett (rom any and all <br />claims for damages that may arise because of installa• <br />tion and maintenance of the improvement hereto <br />applied for and further agrees to remove same upon <br />noj ce fr im�he C,i�y and ro replaco public property <br />Atltlress ' <br />3�S- O�� f �� <br />Telephone Numb <br />.� ;� -- 7�_ <br />Date <br />Dept. Approvals <br />Engineers_. <br />Communications <br />Approved by <br />Dalc Approved <br />