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UI i LIJ�,INLLR� <br />EVERETT, WASH. c `� <br />The Undersigned �.' i r � <br />Hereby applies {or permission <br />At the following location <br />SKETCH <br />IWork to be donel <br />gEvr���Y <br />��ll�. ,'il'i <br />o , ,,._ <br />`t- ,,. <br />`�5 <br />_ � �- � <br />' - �, , � _ . <br />� � �, � <br />, , j� <br />I �.r <br />Jn�,a <br />I�� � ��,i� <br />` �� ��`, <br />0 <br />. <br />� <br />� -- - - _- - ------ -�.-----_ <br />The undersigned owner hereay agrces to hold nnd save harmless the Cily o( <br />Everett from any and all �:aims for damages tho� moy arise because of thc <br />inslallation and mainlenr.nce of Ihe improvemenl hereto applied ir,r and <br />(uriher agrees lo remove •ame upon notice from Ihe City and to reploce all <br />pu6lic properly damag�:d Ihereby. <br />Inspector's Signafure <br />_ Si TE C .�IF�:.(�rii �i'/� '�� <br />Dale <br />Remaiks <br />f:nll Enpineerin� C�,�pL �59�F,z;!); <br />24 Hours bc�forc <br />cnnsiru��tinn is sfarled. <br />� _ <br />`i).7.1 <br />;',2;J,;��,E --�_�� I <br />PRO"N�i� ORAIf`dAGE <br />I I <br />L�.. _ _.... - <br />_..__ l=�t.�7-.i�.cr-:.�_ <br />� Approved By <br />`' /� /5='7/ <br />��i�i� ': <br />Date Approved <br />� ., , <br />��� <br />Vuriancc R^quired <br />Ycs. ... . . __. <br />No <br />� J }— <br />�� ��y ��. �'' .�, .�}.. �'�rt� <br />� � .Si� fure o/ A�licanf /� <br />, �� <br />l� 5 C' �/, G-�%',1 �',�v_ Rlrr,� <br />���dress <br />� <br />`-/ '•- l4 ' -- <br />,. <br />ielephone Number I <br />�,%, /�/ <br />Dafe <br />s �,)r i�-/-�—=- <br />Fee <br />DEPT. APPROV LS <br />Engincerf' '/ �'�'-�r�c��i �/�b �z/ <br />�� - ....i � � <br />�' Watcr �-'- - / <br />Strcef � <br />Communicalions �' <br />Traf(ic ' � �• . <br />Plannin(+' ' `/�'�yj/ <br />' NOTE <br />i'H�C!< IVITH WATEfi <br />fi'-.:''f. FOR t^.�ATER LlflE <br />I.����iSIr�.IVS Pi'cr�FF EXCAVATION '� <br />