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The Undersigned <br />z- J4- I <br />Date Approved <br />Hereby applies for permission <br />At the following location <br />SKETCH <br />(Work to be donel--- <br />No <br />Sc-As-E <br />f_xIST. <br />CUWER7 <br />-73al? ST- S.E. -- - <br />I_n T 1 1 <br />1,603 <br />fl <br />,. I -EXISTkz <br />, 5 <br />DRA <br />c7rrig`� <br />The undersigned owner hereby agrees to hold and save hrrmless thq City of <br />Everett from any and all claims for damages that may arise because of the <br />installation and maintenance of the improvement hereto applied for and <br />further agrees to remove some upon notice from the City and to replace all <br />public property damaged thereby. <br />DRIVEWAY SECTION <br />NO SCALE <br />- 17' <br />I" LIP <br />CrYls J —/S-- 74- <br />Inspectors Signature <br />si7fi c��c�r—�-23~ 74 <br />Date <br />Call Engineering Dept. 611 bbl3 <br />24 Hours before <br />cDnatructlon ted, <br />t <br />• NOTE <br />CHE% WITH WATER <br />DEFT. FOR WATER LINT <br />LOCATIONS BEFORE EXt'nVni it <br />Variance Required <br />Yes <br />No L <br />Signature of Applicant <br />wax <br />Address <br />�$-5 -- c% y Q Z <br />Telephone Number <br />Date <br />9a P 67 AA Fee <br />/-Z/-1¢ <br />�..,, <br />Engineers -?A7 <br />Water <br />KStreet ;! <br />Communicalic <br />Traffic <br />Planning <br />PROVIDE FOR <br />PROPER DRAINAGE <br />I <br />