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� �i•vcrrl� . <br />. ��; .�� <br />f,ITY [f:GIN[L-RS <br />EVER[lT, W,ISHINGTON <br />Tne iinUcniuncd t F' - <br />Hcreby app�ics for pennission to <br />At thc folic�ving ;w:a;iun <br />(Work to ba done) <br />���I�! ;..,.i�1lOfJ PCH RlGtll-Oh .Vn�� i,;,.�` u:'!iP�tIT <br />�� <br />t%� f�' G:��1.sf`�� <br />� j • /2�/� <br />DRIVEWAY SECTION <br />� NO SCALE <br />� <br />\ � ��� LIP <br />. 30� I' 3_"1 <br />-'1 <br />COPY OF THIS APPLICATION TO � <br />DE POST[D ON JO�SITE. <br />CALL ENG�N6ERING DEPT.259�8877 <br />24 HOURS g[PORE CONSTRUCTION <br />�-.. _ <br />Ch:[CK LIS' � <br />YJamr \'alve <br />Draina9r. <br />Curb & '.�.iUer ' <br />Sidewal.: � <br />Inspcctor's �i9nature . <br />� <br />Hemarks <br />Notc: Ori��inal to Cuslomcr <br />, ����Y �� F,�,� �.10 f3 �3 <br />1 Capy Iu In°.p��ctor <br />�10�� <br />� <br />PERAti7Nn, ���;5'�'` <br />—� _.� <br />F}TTF1C;��v <br />The undr.rsigned owncr hereby ayrees to hoid and � <br />save harmless the City of [vcrett from any and all <br />tlaims tor damages that may arise heeause cf installa• <br />tion and maimenance of tl�� im�rover, enr P,�rato <br />applied for and (urU�er agrees to remove s;:� �� upo❑ <br />,iotice from the Ciry and to replac^ pubiic �roperty <br />dartia�::(�tfyereb • <br />�� �f' /� . <br />S ngiiature of AppGcant <br />Lr�i�=.=��t� _ � . <br />Address <br />��;�-%S�� <br />Tclephonc Numbcr � . . <br />-.G� -J. �'- �,�_ <br />oace – <br />Fcc �� .s; <br />• �ept App�ova�s <br />� Engincers�.�� _f.. � <br />, Communications <br />r1pprnvr.d by _ <br />�)IrtU /1�qqo✓c(� <br />