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�on�;��rinni FnR Rir,HT-QF-WA�' USE PERMIT � <br />'s _ i �,.�" � <br /> cverefl ��'.;.� _���� '�/�" ' <br /> � ; �;�, ;. <br /> ;�,�=� <br /> - CITY" ENGINECRS PERMII NO.��_c.�-'�^"�� - <br /> EVERETT,WASHINGTON ' <br /> !-Ir.. �; ; , � <br /> The Undersigned _ ( � �' �� � ' � <br /> : "�4� u��� �; l ,. l� - C1 ' bS/ <br /> �� Hereby applies for permission [o [c � 'f -< < t c 2 5 � L o.- c � <br /> At the following location y � 2 � �� T h �� ��� � _ _ <br /> SKETCH � <br /> (Work to be done) i I �, I <br /> . ! l �'i II . , <br /> I c� ----- — . — i , . <br /> /;� � '�l �..J i <br /> � , ' <.': f � I i <br /> I � 4 _ <br /> � !9 <br /> ' I ' I � I <br /> � 1 <br /> 1 <br /> I ' <br /> _ . r � � 7I <br /> I <br /> � i � <br /> � I I I <br />, �� l � I�� � 1 <br /> _I i C <br /> i %I <br /> 1 � �� I <br /> d // I� <br /> . � <br /> I � - � ' � <br /> I �;� � � <br /> �, � � -- -- -- � <br /> -- — - -- _ _ � <br />�r - �, r �_ _ _ 4 ._,;"_,,.� I �� <br /> i �_ _ " <br /> . �., �.••. <br /> �� <br /> `, —�1—_ILL_ — __ ._—' ". ._ I D <br /> �i3 ''D ; 'r. ::� <br /> 1 <br /> _------_ ,. I � � <br /> � � � <br /> � � � �� <br /> The undersigned owner hereby ag leas to hold and <br /> �. DRIVEWAY SEGTION . save harmless the City of Everett from any and all <br /> NO SCALE � <br /> � ` j , _____ claims for damages that may arise because of insta a- <br /> tion and maintenance of the improvement hereto <br /> � I" UP applied for and further a9rees to remove same upon <br /> 30' I � _�.3�� •� no[ice from the Ciry and to rejace public properry <br /> �—��t�--------�— f ��� , . dam��e her Y/���". � C�'ON�;://c,,.--� <br /> / /. / i� , <br /> ignature of ppli a t <br /> ��) ��n c�%� � <br /> ._ ---... _. _ _ _ . .___, Address <br /> ; �ii"�' OF iHIS APPLICAlION TO ,. % ��F — �/��/�'C 3 <br /> �'. i'('iSTED ON J06SITE ! Telephone Num6er <br /> ��_f ENGInI[6RING DEPr 259-881 I � =� '� / 5�� <br /> Da[e �' � , .� �� <br /> d It )� I��� Bi_I'i,i�C CCi.., U..'li;i.':_ , _�i i � ��_.� ���� / <br /> Fee <br /> FCHEr CK L�ST ge p r Kals -1� <br /> Water valve G <br /> Drainage Engine � <br /> Curb & Gutter �—'� /,j 1i �9' <br /> Sidewalk Water � �j <br /> Street�,� � <br /> `� , Communications � � _ <br /> 1� �;n, �.- �- . <br /> Ir��Ecto 's Signature �fratfic �, <br /> l_. :%-�-_ �' <br /> Plannin9r_ �� �`�'-�-1"� <br /> 1��� � � _-�('_ ,c.�.J;._� ' :' Ti � ,,� �_� _ . <br /> Date <br /> Remarks <br /> Non�: Oi iyin�l to Custo��cr _ �r � <br /> 1Cu��1 tnFilc , . , Approvedby�� � -�/�� � .'7; r--; <br /> i � <br /> 1 " . ' �n Insp�fr,tui __ ._, — ---r--- <br /> �utc�Aliproet�d <br />