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�'!'f <br />CITY E�JGINEERS <br />EVERETT. WASHINGTON <br />The Undersiqned �[��� <br />Here6y applies for permission to <br />A[ the following <br />(Work to be done) <br />J��� Y � Iz r2-c�c� <br />35 � C <br />DRIVEWAY SECTION <br />NO SCAI�E <br />�----- 30 —'� <br />I" LIP <br />I 30" i 30"J <br />P�-'•�—' _ __ - i <br />CGPY OF THIS APPLICATION TO <br />BE P05TED ON JOBSITE. <br />CALL EPJGIP,EERING DEPT. 259�8811 <br />24 HOURS BEFORECONSTRUCTION <br />CHECK LIST <br />N/ater Valve <br />Drainage <br />Curb & Gutter <br />Sidewalk <br />Inspector's S�gnature � <br />0 <br />EX C_ L-ss i �� ? <br />Remarks <br />�.i23o <br />PERMITNO. �S—/q3 <br />The undersigned owner hereby agrees to hold and <br />save harmless the City of Everett from any and all � <br />claims for damages tha[ may arise because of installa- <br />tion and maintenance of the improvement hereto <br />applied for and further agrees to remove same upon <br />no[ice from the City and to replace pu6lic property <br />� ama� ereb . `���_' _ ,� <br />�� ` <br />�1.�-C�K� <br />Signature of Applicant <br />/� �i- 96� �{/` <br />Address�ic•� uciej� e�l� ��Q � <br />��' C R., 7•, 9 EJ x <br />Telephone Numbe <br />.`��� 1 f�S <br />� Date <br />Dept. Approvals <br />Coinmunir.ations � <br />App:oved by <br />CUSTOMER Date Aooroved <br />