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�..-1 <br />. �� <<� <br />CITI ENGINEERS <br />EVERETT, WASHINGTON <br />pPPi ir.nTinni c�o o„-.�,_,.-.. <br />�,� �-u�•-vuaY USE PERMIT <br />P'eR�viiT iJv. <br />The Undersignxd � <br />Hereby applies for permission to i. r - Y ,�: � � / � �3 � � . - � <br />i�_ ��'N <br />At the fcllowing <br />SKETCH <br />(Work to be done) <br />� � �S � " — <br />_ i <br />_ =_�. <br />� <br />: r-� ��� •-� �� <br />� ,, .� °_7 c. <br />t., <br />�RIVEWAV SECTION <br />, NO SCALE— -- <br />r------ _-� <br />{I�� LIP %� <br />�30" 30 <br />_. _- _ _ _ __..._� - "� <br />�. COFY OF THIS APPIJCi1 � �ur�: l�� 7 <br />k;E POSI'ED ON J06SIT[;. '� <br />�, CAL� ENGWEERING DEPT. 25&fS877I <br />"%-0 HUUP,S f;EFORL- COWSI"I�UCI��r�„f <br />CHECK LIST <br />Water Valve <br />Draina�e <br />Curb & Gutter <br />Sidewalk _ <br />� <br />i <br />_ - � [- t� �__TT <br />inspectur'sSignature , j� <br />/ :-; j��-� �. <br />Date <br />'' <br />� ' �, <br />C-ci��-.'� �s_ (i 'Y: .�� . <br />Remarks , ' , j <br />No[e: Original to Customer <br />1 Copy to File ? (� "� � ; '� <br />7 Copy to Inspector �� � � " <br />' �� <br />The undersigned owner hereby a9rees [o hold and <br />save harmless the Ciry of Everett from any and all <br />claims for damages that may arise because of installa- <br />tion and maintenance of the improvement hcre[o <br />applied for and further a9rees to remove same upon <br />notice from the City and to replace public properry <br />damagP,d thereUy. j , <br />�'/ /%, �� <br />��_..�,. -�� ,, . ,... , . <br />i; _ <br />Sgfiature of A plicant --- <br />�! <br />� � <br />Htltlfess — <br />n <br />Te!ephone Number <br />= � <br />Date ----r " � <br />. . . � �. � - ./ % <br />Fee <br />- — �� . � � (,. <br />Dept. Approvals ' /' <br />Enginecrs � .� :. ° ', ' �-� � <br />Water^i' G.;.,. „�,.. �'; � _ . .. ^,,�; c. — <br />Ccmmunications <br />Traffic �� % ' � ; �� � <br />t %i' <br />Flanning � .� ( �,� � iri <br />, � �s., -e-- �—,'i� ii % � � � , c � /"' �j : <br />Approved by <br />^.;c :pprovc�J <br />