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EVERETT. WASH. <br />The Undersi <br />Approved By <br />Dote Approved <br />Hereby applies for permission to ciT�t LST� _ �- f r I/� iS� J-1rA <br />At the following location <br />SKETCH <br />(Work to be done) <br />- — F X I S 7"/NG GUL ✓eRT _ N U <br />Sr:A u <br />Q�, I O r <br />- - - C�$ir= ==G=Td — — ---CP-Dc.e OF PAVs-r <br />01 MINJIMUM DfIIVFWAY SLAC'S <br />25/ O <br />�1 <br /><1 L.U-T A 3 <br />WL <br />The undersigned owner hereby agrees to hold and save harmless the City of Variance Required <br />Everett from any and all claims for damages that may arise because of the Yes - <br />installation and maintenance of the improvement hereto applied for and No <br />further agrees to remove some upon notice from the City and to replace all <br />public property Jamaged thereby. <br />DRIVEWAY SECTION 7t ,. �G/x > <br />NO SCALE, ''' Signature of A pG ant <br />? 1.SSim_ <br />I" LIP Address <br />Telephone Number <br />Dale <br />Inspector's Signature Q ,� <br />Fee <br />s/r <br />Date <br />DEP APPROVAtb <br />f <br />Remarks Engineers <br />Water, `— <br />Street <br />Communications -- <br />Traffic <br />Planning <br />PROVIDE <br />Call Engineering Dept, 259 80343 ' NOTE PROPER DRAIN/,.(-� <br />24 Hours before CHECK WITH WATFR <br />CQnstnlCljgR III ItFied. DEPT. FOR WATER LINE <br />LOCATIONS BEFORE EXCAVATION <br />e ♦Ka �. <br />