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EVERETT, WASH. Appro�ed Py <br />3 �G �� <br />The Undersigned )`� � ' ;- � ; ' � `- Date App o�ed <br />Hereby applies for permission to_ �' � /.J `"7` �1 I � 1; i :i.� ; . � � : , ' i; ; '/� �' fK l !'% �' ' 7 ---- <br />.LV ���.�_���. G.�:= .'�� Inl/L _ �il-_ -_Il�'� /�:` l_�-.� - .. . ..� ,..i __.� A: ` . <br />.'� ��... �j'��,s,;'.. �-�._�, �_.'= <br />At the folhwing lomtion_-- , - <br />SKETCH <br />IWork to be donel <br />��>Gu��F�' !-[_� = <br />., pE izr i•oar <br />7,�nf:. .�., .. <br />.��!_� <br />�(AN TGT � � <br />T <br />r?EMovF' Pr?�7�=�n�; .,� � <br />� /�'I�i�R;..- <br />/ �i <br />r,° <br />.. _ —!O�Ce��cerl[ `�—_ <br />.y <br />� _ .. _. <br />_ >� � -- --_-I 1 __ - <br />3 �� <br />, _. _� <br />> ' _ v� <br />.._-., l ._. ___T ' ' c_._—_—_.'_—_— —_ <br />_ - ---i � � �� Ey <br />The under:igned owncn c�reby agrees to hold and sa�e harmless fhe Ci1y of <br />Everett from any and all claims for domages thal may arise because of the <br />installalion and maintenance of Ihe improvement hereto applied for and <br />Further agrees to remove same upon notice {rom the City and to replace all <br />public property damaged if�ereby. <br />DFiIYEKhY. _.5[C <br />(�1b- ".`,CACE� <br />�`?R :�.� ........ .. .... __ so <br />�C ~ - ,---i.; l <br />Inspeclor's Signafure <br />�S/TF l ;y�C,�E/� 6� � <br />Dafe <br />Call Engineericg De��t. 259�5803 <br />24 Hours hefore <br />construction is started. <br />�(�f� <br />l�]v.. <br />' nOT� <br />CI�cCK VJITH WATER <br />UFPT. FOR WATER LINE <br />L�7L'ATIO�JS pC�ORE EXCAVATION <br />- (�� -� - � <br />Varionce Required <br />Yes _. .._._ _. ._.__.. <br />No__.._....._. _........ <br />/ � <br />,:�"�%���%��� �i�=' Gn�:' <br />Signalure�o Appljcanl <br />'>G) !�=-.- / ,i _ �� /%" <br />''� -t Cl�✓=� <br />, � aad,e,� <br />iX �' ,;1 '- Cf / �j l'�- <br />iclephone Number <br />%;%j��..�r�_ .T � � �/� G�� <br />,� Dalc <br />5 �, mn �%� <br />L <br />Fee �. V �.- 7/ <br />DEPT. APPROVAL; <br />✓-, . - <br />Enginee s� ' <br />Walcr - ��_ <br />Strect — -� -- - <br />Communications _�� <br />TraHic `� `�-'� �, ; � � , <br />Planning ' ���`�_ % ^ � �� <br />j PROViDE FO�Q—``I <br />PRUrER DRAINAGE <br />