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QTY ENGINEERS <br />EVERETf, WASH. <br />Approved By <br />�,f i. " �� i � �-� Dale Approved <br />The Undersigned � *�'- � - ,� � �` I"� <br />Hereby applies for permission to ���, � ,��X��� '�/� ^ "�,/ � ��`� r <br />�11.:�i'./�f/:l1�i -'7 <br />— a , <br />� <br />At Ihe following locafion —% a'1 � �� ' J C. -'' -. ="�1 <br />(Work to be donel y <br />� <br />-- � I <br />I I � <br />I I I 2// <br />- - - � = _'�-`_ y� ��..��a <br />__ _ -- ----- —' �.- ---- <br />�.� r, � �- <br />, � , _. <br />H�� - , <br />The undersi�ned owner hereby agrces lo hald and save hormlcsz �he City of <br />Everelt from any and all claims lor damages thol may arise because ot Ihe <br />installation ond mainlenancc ol Ihe impwvemenl hereto applicd for and <br />(urther agrees lo remave some upon no�ice from Ihe Cily and to replace all <br />public property damaged ihereby. <br />DRIVEWAY SECTION <br />NO SCALE <br />�•---- �� � --� <br />I" LIP <br />r30" L _I_30" <br />$ignofure <br />Dafe <br />1� �;,all Engineering UepL 2', � `v1�� <br />I 24 Haurs before <br />�'°'� wnstructinn is st;rre�l <br />;, <br />•: f � <br />i_.. ` <br />Voriancc Rcquired / <br />Yes [� <br />No <br />- i <br />� ". . � , � i_ i- :�� `",1_ .. .` <br />Signafure o( Applimnl - <br />_-.�_,_. _�-- <br />G' y4ddreu _ -i �� . ' ,r . <br />�-��� <br />/' ',i ' !' � <br />' ielephone Number <br />�//� _ _ . . <br />� <br />Date �3 <br />S . ,����� ����J � /��l ' <br />ij .� � "''`_ <br />/ L; �i1 , j. �.,_ ��_ Fee <br />�'`- . <br />/��� �� <br />OVIC[ FGR <br />�'�30PER DRAItJAGE <br />DEPT. APPROVALS <br />Enginccrs - <br />watcr �� �� �� %t,��i �5��� <br />SIreM `���_,J. /'' %, _, i 1� . <br />�y� <br />Commvnica�ions "fi�' ��� �� � <br />Traffic : �.'z't.: i. ;'� S� iJ3 <br />� <br />Planning - , <br />' NOTE <br />CHECIC Wi7H Wt1TE��. <br />DcPT. FOR VJAl'LI?:_" <br />: `,Tli)tJS F3EF0� � ,,.71'� . <br />``` r , � <br />�Ko �. <br />