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rvercti <br />\� <br />CITY ENGINEERS <br />EVERETT,WASHINGTON <br />APPUCATION FOR RIGFIT-OF-UJAY USt PE�iMIT <br />PERMIT N0._����r�_" � <br />The Undersigned _f ': �l i � ��.�% � � � <br />Her oy applies for permission to � �i �..i �7 r, �. �C T ,-i = < �, i. , �. " - �-� � i <br />(Work to be donc) <br />.�,-' �_ ;.i.-'- <br />�-.-�.. .�, <br />DRIVEWAY SECTION <br />NO SCALE <br />� — - —� <br />C+I" LIP � <br />��o�� � ____,��30� <br />, -T�---------- - <br />COPY OF 71+IS Ai'PLICATION TO <br />BE POSTED Oi! JOBSITE. <br />CALL ENi;IfJ[ISRIiJG DEPT. <o9�8£il l <br />"�'-rOFlC COPJSTRUC1�IOi�.r <br />CHECK LIST <br />Water Valve <br />Draina9e <br />Curb & Gut[er <br />Sidewalk <br />Inspector's Signature <br />Original to Customer <br />1 CopY to File <br />7 Copy to InsP�r.tor <br />The undersigned owner hereby agrees to hold anu <br />save harmless the City of Evere[t from any and all <br />claims for damages tha[ may arise because of installa� <br />tion and maintenance of tlie improvement hereto <br />applied for and further agrees to «move same upon <br />notice from the City and [o replace public property <br />damage1d therepy,.J i� � <br />% Jlr��✓" �.r��i / �,_ <br />Signature oi Applican[ <br />�i-� l� G�[/�jq�.niFiFH / /�-�� <br />Address -� ,� � . j <br />.(�i.!->7U� <br />Telephone Number <br />//- //n-77 <br />�� �/ .j <br />Fee �i c —y-r. .—_'; ,, . <br />i � <br />Dept. Approvals <br />Engineers �i�. <br />Ccmmunications <br />