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ENGINEERS <br />i�TT, WASHINGTON <br />PERMIT NO. %� —�S_'��i <br />The Undersiyned _ L�4 �J .'-_ . �r � I '�" �1 "� <br />Hereby , pplies for permission to _ G S:_ , �,�, 7- ��-, � 1 0' r r <br />- ti • r� c �< <br />�.�� i �i :. �._> r� ..; -- ---- <br />At the foliowin9 location <br />•/. % / �% . <br />(Work to be done) <br />�� � L !_...i• ��_.0 <br />�- i .��� ;-, .__ . �� .�. <br />I l-lL%��/L� � ? <br />CK�'LLSi/C� r�C� � <br />o�vrvEwar s=_cnou <br />NO SCALE <br />�-'----�-- ------'� <br />��___jl,� LIP <br />I--30"-'--- --"--- ----l-30"-I <br />CO°Y OF THIS APPLICATfON TO <br />QE POST'cD ODl JOBSITE. <br />CALL Ei�GIN�EAhVG DEPT. 259-6811 <br />2�1 NOUf�S �EPORE CONSTRUCTION� <br />�CHECK UST <br />vi,�d� �,i�z <br />Draina9t <br />Curb & Gutter � <br />Sidawalk <br />��_ r � /. <br />-Q,'_..c�� ' �`� � <br />Inspector's Sipnatule <br />'__._�--/ � <br />Dafe — <br />i? � c G�s� -?-� <br />;=•,f�'� , l I � r � <br />Remark� �l <br />�.1 � 3 � <br />CU370H3:i <br />�:� �l J'/C 7.-, , �; . . : � <br />7he undersignad ownzr hereby ac�rees to hold and <br />save harmless the City of Everett (rom any and all <br />claims fur clamapes tha[ may arise because of installa- <br />[ion and maintenance of the improvement hereto <br />applied for and further agrees to remove same upon <br />notice irom [he City and to replace public properry <br />d;. nage/ fithereby, �� <br />�l�C'� �1Jt� , o_ •: (,! (.t 'l <br />Si,na,ure of Applicant � <br />_(_�'!i� bJt/�`/G^,�4.� ��C.v�. <br />:.d::rrss <br />�_ �"�_ r4'... T_'r'". G!J ri—� �� . %�.20 3� <br />Telephone Number <br />iSS — `�`Y � / <br />Date <br />Dept. Approvals <br />Wa <br />Ccmmunications <br />Approved 6y <br />Da[e Approved <br />� � <br />. ' ' . . � e r , � i �' � �.. ' ' - <br />—..�_.�..._.'=.-.ry.-�. w...�- ,.. _.�._� _ �._ . .. . .. _ . � _.— � •r._ tl ..� _:J _ . <br />