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The Undersigned <br />f <br />Y <br />Approved By <br />Date Approved <br />Hereby applies for permission to— LOW S mU C T cC — Z '5 F 7— AS 61 J ?i L 7— <br />At the following location 1731 / 4—'-"� S T 'T ' E <br />SKETCH <br />(Work to be done) <br />fULb aP <br />The undersigned owner hereby agrees to hold and save harmless the City of <br />Everett from any and all claims for damages that may arise because of the <br />installotion and maintenance of the improvement hereto applied for and <br />further agrees to remove some upon notice from the City and to replace oil <br />public property damaged thereby. <br />DRIVEWAY SECTION <br />NO SCALE <br />+I" LIP <br />� 3 r <br />Inspector's SignalT <br />5277F- CHECKED 4-25--7-3 <br />Date <br />Remark$ <br />CS eegineerini eW An „j j3 <br />14 04w t1Anr. <br />fOflSlfvt/rw � . <br />VALVE f�OX <br />pl Ra HYDFLFW r <br />1'(UTE <br />CHE^K WITH WAM <br />0:'PT'. FOR WATER LINE <br />LOCATIONS BEFORE EXCAVATM / <br />74 7,`/ <br />S7— <br />Variance Required <br />Yes <br />No <br />Signature of Applicant - <br />V 'Address <br />.;53— - z/ <br />Telephone Number <br />-/¢-23 <br />Date <br />: <br />`Zr.JA Fe:cT'-9 z 147 <br />tiMt4� <br />Engineer '`-'''v`"' <br />Water, <br />Street <br />Communication$ <br />Traffic <br />PROVIDE FOR <br />PROPER DRAINAGE <br />Ix <br />Pyc;i , s., / NcS ra ,Kt�tiHQ Tdlrcw�/`I IvQ <br />V bOk. <br />