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- � _ �� <br /> ,._- <br /> � _ -_����� � <br /> •�t�rcll AI'PIJCl�"fl�;�l I=OH I�1Gfl f-OF 'vV/\'( USE Pf�f:i�;;ti r <br /> i`;`-_\ <br /> (� � <br /> � CITY ENGINf_GRS <br /> i <br /> EVEHLTT, WqSlIINGTON <br /> � NEI?��111'lJO. <br /> � TMa Unticrsigr�^� --�---____ <br /> Hereby appGeS for pennission [o — ---_�_ <br /> � At the following lacation <br /> � "----- <br /> SKETCIi —'--- <br /> (Work to be done) � <br /> � <br /> I <br /> DRIVEWAY SECTION � <br /> , NO SCALE The undcrsigned ovmer hereby agrees to hold and <br /> —� save harmlr.ss the City of Evcrett from any and all <br /> � claims lor damages that may arise because of instaCa� <br /> —'-�-�'�P tion and maintenante of the improvement hereto <br /> 30^ I � 3� I a lied for and �urther a,rees to remove same upo t. <br /> � -�- - - -_.—�-_e� P� <br /> no[jce from the City and to rep�ace public proper.y <br /> da gedM1hereby. � <br /> a <br /> J��"��,��� � ,� <br /> Siyna ure of ApPlicdnt . <br /> COPv OP -iH15 APPLICnI"ION TO �'=' �C� �"L.r:��.., �,�,., <br /> 6E PUSl'GD ON JOOSITL. <br /> Address '� <br /> C:9LI_ 6NGINC-ERIIJG DEPT. '259�II811 \3���� ?y�� <br /> Telephonc iVwnber <br /> 24 IiQURS p�PURC C0�!STRUCTIOiV �' ��' - �n <br /> --------�— � Uate <br /> CHECK LIST � <br /> 4Y�mr Valve , Fee <br /> era�na�e Ce��[. Approvnls <br /> curb & Guctcr �- � <br /> Si�lewaik Enpineers. <br /> Water --------- <br /> Strce[ — <br /> Inspector's$i�naWre ' . Cemmunications <br /> Tiaffic — <br /> - Plannin9 — <br /> � U;lc ---- --- --=— <br /> I —_____— -- <br /> � Rcinarks--- __.___._'__----------- <br /> I idnre: Original fo Ciatomr.r — ..---' -- - <br /> 1 Copy to File 7 j � r: il <br /> I I i;r�py to In<r,�:�:Wr J.. ���l� J �.• '_._ <br /> � Approvr.d uy . <br /> i _._____--_ . <br /> • . _ _.._—.___. <br /> .. . . �____..__ <br /> �i.:; � i1�v i:',v,u: ._'_ _ <br />