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� '— -�� APPLIC47'OOR r��rliT-OF-VVAY USE PCRMIT 1 <br /> (cverclil +� <br /> 1 U .� �,1 .' �� �,� _ <br /> -_�� <br />� CITY ENGINEERS _� /�� <br /> f EVERETT,WASHINGTO�' PERMITNO. /� <br />� <br /> The Undersi9ned ��N.�J� /y���s�/f/ <br /> Hereby applies for permission ro C/)/�.S%' /�CT c� 1 � ( "(�/���?�� 1'�,�/l/�/�(/A� <br /> I ;� <br /> I <br />� At the following locati�n_ <br /> /C� FJ L�c � (- -- -- -- <br /> S::ETCN - <br /> (Worl< to br. done) <br /> `� i <br /> � <br /> � ! <br /> � � <br /> a <br /> -- _- � ( N D <br /> S C!iLr=_ <br /> I <br /> 92 �� S ,T 5.�. __ j <br /> � <br /> E�iSTi�fc� cuRL3 ^j ' <br /> �Ur7�.P. �'' S�C;_:�iir�'{� � ' <br /> --- --a � <br /> A/E6�1 GONCk' DRIVEki/�;` <br /> � <br /> J <br /> `.;y 9Z0 I i <br /> _ 18� <br /> � <br /> -- , � <br /> , DRIYEWAY SECTION I The undersigned owner herehy agrees to hold and <br /> NO s'cnL save harmless the City of Everett from any and all <br /> � — �� - � claims for dama9es that may arise because of installa� <br /> +I" LIP tion and maintenance of Ihe improvement hereto . <br /> �� applied for and turther a,rees to remove same upon . <br /> �.30'� ��_ . 30' notice (rom the City and to rep�ace public property <br /> dam ged ^�ere ' <br /> � p�;�l � � � � -� �, � <br /> S' a�ure of Applicant � <br /> yr <br /> i— _ ____. __ _.. .._ I � 4 <br /> , COPY GF THIS APPLICP.TION TO I F Address ,' <br /> � � '- POSTED ON JOBSITE. , '� 7 _ �d <br /> ��.'._L [P,Gi� ! r r � Telepho�ne umber — '� <br /> . ' lE[R ��� D6PT. 2�9-0R17 ' <br /> , I;!Lif; _!-:.�RP � n;�ls'?PUC�IUFI� Date � <br /> � � - - �� /� SO -`�=�'—�� . �/s�� - <br /> `J 20` <br /> CHECK LIST Fee - <br /> Wator Valve D�pt AppfoVals <br /> Drainage � <br /> r" <br /> Cur6&Gutter . ,. Engineers� ���iGf�!'�-���-��'�' '' � <br /> Sidewalk �<¢ �:. . I <br /> — , _ . . - Water -� : �" .�- �j-25 7S I <br /> � , �;r <br /> � <br /> � =.� ' i (; , Street_ ��` :_ .__ , <br /> � '-�� Communications � � . '�,.... �_cp � <br /> Inspec[oi"s Sig�ature � <br /> -- Traffic / / '"..,r� '� 1.- // � <br /> � Pla�inin` � �: ' � <br /> USte^ / / '� r <br /> ",-;-:' -, :.% <br /> Remarks ��� <br /> Note: Original to Customer q � <br /> lconvtoFile 1�� g3 / <br /> 1 Copy to Inspcctor Approv d { <br />¢ �� %Li.`-rv:,� �" � -+� <br />� i — `S/.� <br /> Da��e Appro4ed <br />