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U <br />CITI' [NGINEEI. <br />EVERETT. WASHWGTON <br />PEHMIT NO. ' �" �' <br />The Undersigned _I.�'��__� ..L'�':. � -- --. <br />Herchy applir.s tor permission to j<'�r'•,a y'<� .�• i� i� / � F� �'. �r7 i" j' 7'� n/�� C iT1�Q. u/ <br />i <br />At ihe (ollowing location <br />SKETCH <br />(�Yoik to be done) <br />r <br />DHIVEWAY SECTIO�J 1 <br />{.___ NO SCI+LE <br />1 � <br />�— � I" LIP <br />i.3o,�_ .�_ .._ . _ .�.30.� <br />CO'•'i Ur T�NIS APPUCATION TO <br />BE POST[D ON JOBSITE. <br />CALL GIJGINEFRING l)EPT.259�d811 <br />2M1 HOURS OEFOR[ CONSTRUCTION <br />�_— _--_ <br />CFIf �1K LIST <br />Watni Valve <br />Draind9e <br />Curb & Gutter <br />S�dewalk <br />�. <br />pector�s �9 alu�—__._ ___ _ _ __ _ <br />9 Iz.-�� . <br />Date <br />Remarks � � �. � C � <br />J <br />�� <br />Z <br />� <br />� <br />r <br />Thr. undersipned owner hereby ap�ees to holrl om; <br />save harmless the City ol Everett f�om any nnd adl <br />claims lor damages that may arise because o( inslalla� <br />tion and maintenance o1 thr improvement hcrelu <br />applied for and luriher a9rees to remove same upon <br />notice irom the Ciry �md to replace public property <br />s��c <br />Date <br />Fce /1�J h F�� - <br />Dept. Approvals <br />Engineers_ <br />Cammun <br />Traffic__ <br />Plannina_ <br />qppr ed by <br />CUBTOMER Da��'ro etl '"�'a� o <br />��.A.!�..�,.....�..�....w�+.�.-. I ...�+�...-mw� t . i��-- <br />i. � . . � . , ; / <br />. ......' ....�.._. ..t�... ...... . ..� . .. . . _ . , . ' .,�. <br />