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T <br />� <br /> Type or pnnt cleerly with mk <br /> PRESS HARD- YOU ARE MAKING COPIES <br />( PUBLIC WORKS PERMIT NO. ` ` <br /> EVERETT,WASHINGTON � . <br /> l.ir\ <br /> qpPLICANT (UNDERSIGNED) AND FIRM REPRESENTED, IF ANY: � <br /> HEHEBV APPLIES FOH PERMISSION TO ' �' � ' � ' <br /> . r ,, � .�:. i .. _ <br /> AT THE FOLLOWING LOCATION - <br /> DRAWING (WORK TO BE DONE) OR THREE PLANS ATTACHED: <br /> i <br /> N`� q�ea.f lu+� pn b�t .+. 9 <br />� 1 <br /> I <br /> G <br /> 1 <br />� C +`C• o. $�w •., <br /> e K•���`* <br /> Tl, �•�� ,r �� �f <br />, , y _ s�. <br /> k <br /> ✓ ��_��- e� <br />�I <br /> ��� <br />� DRIVEWAY SECTION <br /> I �_ � <br />� PERMIT IS VALID FOR 60 DAYS <br /> h COPY OF THIS APPLICRTION TO BE POSTED i" LIP <br /> r ON JOBSITE. �30'� _L3o" <br /> CALL FOR INSPECTION 259-691 1 <br /> 24 HOURS BEFORE CONSTRUCTION Tne undersigned owner hereby agrees lo hold and save narmless <br /> the City o� Everetl Irum any nnd all claims lor dnmages, cosls. <br /> e+penses,or causes ol acUon ihal may a�ree because ol installnlion <br /> and maintenance of 1�e improvc��ent or olher rig�bol-waY ��se <br /> hereto app�ie� for nnd lur(her dgrecs�o remove same upo�noiite <br /> Irom Ihe G�y �nd 10 tCpiBCc pubLc O�opc�ly tlamagcd IhC�Cby. <br /> DEPARTMENT APPROVALS <br /> sEwEn coun+uNicnnoNs <br /> OR/•iNAGE TPFFFlL ( . . <br /> p�pNNWG SIGNAiUAE Oi PPPLiCANT' � <br /> \YAiER �� . � y. <br /> / • <br /> PODA[5$ <br /> ST�iEET . , ' � / <br /> /� CITV .. � .� ZIP <br /> � <br /> qPPf�ED FO�CONSTNUGTION /Z—/°AT�Q ' �" �� ' � <br /> TEIE�NON`E NUI.IpER� ALIE�NAIE <br /> � /� ! - <br /> APPROVEDASCONSTRUCTED <br /> OATE OATE <br /> �9�8 � <br /> IP�!;ll:��.I. IP:SI'i_��I�IC�iJRL��UES�f�icD 'F� � <br /> l_ i <br />