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- -�_.�._ . . . . ._ . <br /> APPLICATION FOR RIvNT-OF•WA� �SE PERMIT ���g7 <br /> �. eve!en � <br /> �: e <br /> CITY ENGINEERS PERMIT N0. � -- <br /> EVERETT,WASHINGTON <br /> _ � — <br /> � ;heUndersigned '�.�—" � ,� - ,�, �"� �_ i/�__ . <br /> �.; —. <br /> „ � <br /> H�reSy applies for permission to , <br /> — i � --- <br /> At the followiny locatiun �_ � <br /> SKETCH <br /> (Work to be done) � <br /> � <br /> . _i ;—. .r � " �� . <br /> I I <br /> I I <br /> I I <br /> � <br /> I <br /> i <br /> I <br /> i <br /> � <br /> � The undersigned owner herebY agrees to hold and <br /> DRIVEWAY SEC710rv savn, harmless the City of Everett from any and all <br /> � NO SCALE _ � claims for damages that may arise because of install8- <br /> — 1 tion and maintenance of the improvement hereto <br /> � � —'-71 applied for and (urther agrees to remove same upon <br /> _ �� � � <br /> I I notice from the Ci[y and to repl�Pro�Y <br /> �.. I 30.�_ .--�----�- ---�I'30'1 dama thereb �� <br /> � �F i t.i �iz_Q? <br /> , Signature of Applicant ' <br /> �� ��.�' —� �� <br /> T �C/L_ <br /> - - ^d�� l �,�� ��q � <br /> __ i �.,w; .�.= t.- _�T <br /> COPY' OF THIS APPIJCAI"I�rid �i0 � Telephone�mbe�� ( � ' �� <br /> BE POSTED ON J06SITE. —��., = ; <br /> I CALL ENGINE[RING DEPT. 25&6811 �I; Date J � <br /> � ^' HOURS L'EPORE CONST��UCI IC�iJ�I � /� �. . <br /> � _`-' _. . _ Fen _ ��. 7�iG '�% <br /> CHECK LIST ' Dept..Approvals <br /> Water Valve � � % _ <br /> Drainaye Engineers , <br /> � Curb&Gutter . , y��ier �--- <br /> Sidewalk i � � - Street <br /> Ccmmunicaiions <br /> Traffic <br /> Inspector's � <br /> Planning <br /> fJate <br /> —--- -- <br /> Remarks _ <br /> Note: Origical to Customer � n�R .� qp��oved by <br /> 7 CopY to Pile l l <br /> i CopY to Inspector <br /> Date Approved <br />