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The Undersigned ' � ' ' ��� �� <br />Hereby applies for permission to -->' ��� <br />��. <br />� - -j <br />,� � <br />_ , _ . � � , "� ._ / _ � , <br />At }he following bcation �'� �`.�" ,�� � 1 O U G� L <br />SKETCH <br />(Work to be donel <br />— - tt <br />I��_���i�. � <br />� I <br />I <br />'--`—� � -- <br />ihe undersigned owner hereby agrces to hold and save hormless thc City of <br />Everetl from any and all claims {or damages �hat may arise because of ihe <br />insfallation and maintenance of the improvemenl herelo applicd for and <br />iurther ogrecs to removc same upon nolice from Ihc Cily and to replacc al� <br />public property damaged Ihereby. <br />DRIVEWAY SECTION <br />NO SCALE <br />I----- � S � -i1 <br />� I" l.l P � <br />�� 30'.T. .}:30 '.1 <br />\�' �' " �'� PCW�� <br />Inspec�or's $ignolure <br />�% � � GN�e��r� /� -// �.� <br />Dafe <br />t":.�+"�,.•-, ., . . .`.1" <br />�:; How� before <br />l. .I�..i (j��ti��� �. <br />. t u K,�,; i ri ~ ,��, <br />� pT F�R WAl fH LINE <br />�RE EXCAVAiIf)td <br />G <br />�,-iv- �� <br />Date Approved <br />' ! �- <br />��-� �Ft�� <br />� _ _ __ - <br />�I . <br />,✓` l 1 ', � . <br />�, <br />f:r=c= : i'�'rr.�., i �` := co ( `J <br />Varionce Required <br />Yes.. _ ...._. _._ ..__. <br />No.._ ..... ._.._... <br />� �'� -!'% • � <br />. . i�z� :� �� <br />—�.Sgnafure af�Appliconl <br />, ..�t <br />�'y c> y �; � i'.: «y n-/ <br />Address <br />3',- 3 _ �t5.�,- <br />Telephone Number <br />%� � / _-. � <br />� <br />,po oar 3�t9 <br />6 — l�'�2 �Pr����F <br />a �S= ,��--Pd �����6/73 <br />I�'C�U F 7j � Fee �' 3�3�� <br />� �`t(, ro � <br />DEP APPROVA2S <br />Engineers ' � "�r rv � 7 73 <br />Water � � �--Q�/ <br />Slreef "�— <br />Communicalions��'%� '+.. —'%.. <br />,. �. <br />TmHic i- ._���.'.�:.:.. <' <br />Planning �.` - � . - ��' � <br />� .,, , <br />' i <br />k, �.,;....�..�..�.> � ,..� -- <br />