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CITY ENGINEERS <br />EbERGTT,WASHINGTON <br />PERMIT <br />The Un:fersigned — <br />Herehy applies for permission w_ <br />At [he following <br />(Work to be done) <br />{ DFIVEWAY � <br />1 `-- NO SCAL� <br />� � _ <br />• — +�.' � ia <br />: 30 _-- _— <br />� <br />� � The ndP � �ad �wner reby agrees to hold and <br />�. �_ �, � save harmless the Ciry o Everett from any and all <br />claims tor damages !hat ay arise because of instalia� <br />� tion and maintenance of the improvement hereto <br />applied tor and further agree� :o remove same upon <br />I 30'y� ___ notice �om the Ciry and to replace public property <br />� .---�--�-�%-- t T� , ✓ � �� damaged thereby. <br />��� � "`Signature of Applicant <br />COPY OF THIS APPLICATION TO <br />BE POSTED ON J06SITE. <br />CALL ENG�NEERING DEPT. 25�-8811 <br />°4 HOURS BEFORE CONSTRUCTION <br />CHECK LIST <br />Water Valve <br />Drainage <br />Curb & Gutier <br />Sidewall: <br />Inspector's Si9nature <br />Remarks <br />1'i 21.7 <br />Telephone Number <br />Date <br />Fee <br />Dept. Approvals <br />Engineers — <br />Water — <br />Street — <br />Communications <br />Approved by <br />I ILL COP'! Dale Approved <br />