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EVERETT, WASH. <br />Approved By <br />iz�gze.�.eZ, /, f � 7 7,,,) <br />The Undersigned g 1 A L Ly (, u i 4 TO P N E E" 0'J Dote Approved <br />� <br />Hereby applies for permission !o F A I f E (' R N pr" O E- I- f y F OR 1-9 <br />At the following location L; '5 �. 7— P 1 I C K F F A VE — <br />SKETCH <br />(Work to be done) <br />_Z07'EN) TIF/ANGLE <br />a <br />44T H <br />The undersigned owner hereby agrees to hold and save harmless the City of <br />Everett from any and all claims to, damages that may arise because of the <br />installation and maintenance of the improvement hereto applied for and <br />further agrees to remove some upon notice from the City and to replace all <br />public property damaged thereby. <br />q <br />t <br />r <br />Inspector's Signature <br />Dale <br />n-. n l 'Q i� LN n4o rL <br />✓/:Y/tT T ,�-��STH C,CM -i r10 <br />Call Engineering dept. 259-8803 <br />24 Hours before <br />Construction is started. <br />PROVIDE FOR <br />PROPER DRAINAGE <br />NOTE <br />CHECK With WATER <br />'PT. FOR WATER LINE <br />-'' ""z REFORE EXCAVATION <br />14 <br />t3 <br />12, <br />ST <br />Variance Required <br />Yes.. _. __...._ __...... <br />No..... ....... <br />V <br />1 Signature of Applicant <br />-AAir,�`,,�.. <br />Telephone Number <br />Date <br />Fee <br />DEPT. APPROVALS <br />Engineers <br />Water <br />Street <br />_. Communications- <br />Traffic - <br />Planning <br />I <br />