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APPLICA I ION 1 011 11,(.! 11 Ill -KAY USL I'LlUNI I <br />. nvnrt•It <br />;ITY ENGINEERS <br />EVERETT, WASHINGTON PERMIT NO. % 7 _ <br />rho Undersigned_— <br />lereby applies for permission to e o &-5 T?tom T T <br />ktthefollowinglocation -7%ro <br />Work to be done) <br />Co/x,Ad .LD// 1 .�p-va. 0.1,A 4739VII-11 <br />does -;�P&74 fi t /%►... ,. <br />011, *-7 7 <br />DRIVEWAY SECTION <br />NO SCALE <br />1" LIP I <br />'OPY OF THIS APPLICATION TO <br />3E POSTED ON JOBSITE. <br />:ALL ENGINEERING DEPT. 259.8811 <br />?4 HOURS BEFORE CONSTRUCTION <br />;HECK LIST <br />'rotor <br />Valve <br />drainage <br />.urb & Gutter <br />iidewalk <br />nspector's Signature <br />ate <br />iemarks <br />late: Original to Customer <br />1 Copy to File 10841 <br />1 Copy to Inspector <br />The undersigned owner hereby agrees to hold and <br />save'+armless the City of Everett from any and all <br />claims for damages that may arise because of installs• <br />tion and maintenance of the Improvement hareto <br />applied for and bother agrees to remove some upon <br />notice from j0d City and t%jg4lace pb4pc property <br />,x i s 547 - V'av3 <br />A-f9 - /aa I <br />7 <br />Fee `i i•�0 pt.Approvals <br />Engineers�f <br />Water <br />Communications <br />Planning <br />Approved by <br />Date Approved <br />