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EVERETf WA�`i Approved By <br />� J. . / I�� / � <br />i!J "' , <br />� Date Approved <br />The Undersigned �� � � � -� ��'-_� � ' �' `_ � � `` <br />� �, �-- , • .; i •. � : ' `•.1 <br />Hereby applies for permission to � > > � � �� �-'� • 1 � � '"'�~` �-� �''�`�' ' ' V I-�- ' <br />-7/.-�- ( O _ _ � - t � h= ;�� �,1=-- = �= <br />At the following locafion - <br />SKETCH <br />IWork ro be donel <br />/� . -- -- � �-i1-I <br />�T S.E. <br />The undersigned owner hereby agrecs to hold and save harmless the City of Vorionce Required <br />Everelt from any and all claims for damages Ihat may arise because of the Yes.____._. .._._.._. <br />installation and maintenance of the improvemenl hereto applied ior and No__.._._... _._...... <br />further ogrees lo remove same upon nolice irom the City and to replcce all <br />public properly damayed thcreby. <br />DRIVEWAY SECTION <br />NO SCAL�. <br />- ZS <br />L� f I' LI P <br />30 � _30"_� <br />, ,, , , <br />CG'r�'� .�l � :� " ,' i� .�. >.� il.-�; � <br />Inspecfor's Sic�nafure <br />,/ // , , <br />/i � "�i'l/ � -/� �Y 1 �:Y�: <br />1 <br />Dale <br />!i ';i ipedri��g i'�:pL 1�ie;1�.; <br />t l Hours before <br />...- �i��.;IS Sf�if�0ti. <br />' f�OTE <br />CHECK 4VI1H WATe�� <br />nrPT. FOR vv'ATER u,;E <br />�=:�10`:S E3EFORE EXCA�:'.`, � <br />� �� <br />K�.- � <br />�� �J � <br />Signalwe of Apphcanl <br />' 74� 0 1`t�'' AvE 3 ver.�, ; <br />Address 98 i� 3 <br />3� 3 - 3 `78 L� _ <br />ielephone Number <br />io�a l +�'9/1� �� /t��t�c� <br />s �?� `�= .�� -�-�� <br />i i <br />:i �` X`-�- Fee ���/9' 7 r, <br />`� — "� � TC. <br />DEPT. APPROVALS <br />r <br />Engincen��.. � _ �����T��ri�� (-.��I- %�l <br />! � <br />Water �-'�'+' . 4'1`D <br />Street J'-� �-�_-'�/.,, �. . — <br />Communicafiont - - <br />Tmffic /' - : ''��- <br />Planning �� '� <br />PFt:�PcR DRAii;Aiit: <br />r_n.�tr�w'�-r'Y.::.tu'Qe�s.—c�.:.s.��.._I 1 ",• <br />� <br />