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everett <br />� " � <br />CITY ENGINEERS <br />EVERETT, WqSHI <br />The Undersigned � <br />Hereby applies for permission to <br />At !he following location <br />(Work to t� d ne) <br />C- <br />�r � <br />a <br />� <br />� <br />� <br />:, <br />J <br />1 <br />..rr��...,�ivivrvr,ni�,ni•�r•vr,vr VJCI'Cf11Vl11 <br />;� �,,�--� � ��,, �.:r��i�n�- <br />.�'��i��G- �, r. <br />�7 � <br />L <br />� <br />c <br />J <br />, <br />W <br />Q <br />� <br />� <br />� <br />� <br />--- �n�- �N�"n <br />ORIVEWAY SECTIOA <br />NO SC4LE <br />� ��., LIP —�� <br />�-..4�.-- __ 30' I <br />�1 <br />;;OPY OF THIS APPLICATION TO <br />de POSTED ON JORSITE. <br />CALL EYGINEERI�G DEPT. 259�8811 <br />24 HOUHS �EFORE CONSTRUCTIONJ <br />CHECK UST <br />�Vater V�Ive <br />Drainaqe <br />cuib u cuitcr <br />Sidewalk <br />Inspector's Signature <br />4 <br />W <br />� <br />7d ��d/ <br />PERMIT N0. <br />The undersigned owner hereby agrees to hold and <br />save harmtess the City of Everett from any and all <br />claims for damages that may arise because of installa- <br />tion and maintenance of [he improveme�t hereto <br />applied for and further a9rees to remove same upon <br />notice rrom the Ciry and to replaca public properry <br />emay thereby. p <br />A�r1n, ��� ��Y2.� � f�ra. <br />Signature of Applicant <br />Address � �J�'� �. . n E �1 on�SvJ <br />1�59- �a �g qsa�io <br />Te ephone Number <br />� � �� <br />Date <br />Dept. Approvals <br />Water <br />� � <br />StreeL , i <br />Communications � <br />Traffic <br />PI�..��.. � <br />1 <br />_ + <br />112&7 i <br />AVnroved bV ; <br />����M=� Date A <br />pproved <br />. ...sz.aiom+�...e.�..-.-.ea.w.er...�...s,-....n-.....,..-...-.�__..._.,.� �.. <br />