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6507 BEVERLY BLVD 2016-01-01 MF Import
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6507 BEVERLY BLVD 2016-01-01 MF Import
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Last modified
5/12/2017 10:47:03 AM
Creation date
1/23/2017 1:06:12 PM
Metadata
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Template:
Address Document
Street Name
BEVERLY BLVD
Street Number
6507
Imported From Microfiche
Yes
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, <br />/ <br />Permit No. _. _ _. <br />;; <br />;� ', <br />,. <br />- ,, <br />CITY ENGINEERS � <br />EVERETT, WASH. � <br />The Undersigned� �-__ <br />Hereby applies for piarmission <br />At the following lomtion �. <br />SKETCH � <br />IWork to be donel <br />everett <br />APPLICATION FOR D�IVEWA'Y PEftMIT <br />i ! �/ <br />_ - -_ '. . � ' / . �/ � <br />l-'/ ✓. 1�-'.'_�!L'. <br />�' � <br />-_a <br />; <br />�� <br />,' � <br />, -�7t( <br />Approved By <br />�r�'��1-L. � /r �'Y �L <br />Date Approved <br />r <br />,-__� <br />;<; , <br />,� <br />� <br />B� \,_ <br />� �f. ,. <br />� �< y <br />� <br />The undersigned o�vner hereby agrees lo hold arid savc harmless ihe Ciiy of <br />Everetf from any and all claims for damages ihat may arise because of the <br />insfallation and main�onance ol the improvemenl hc�cto applieu for and <br />(u�lher agrees ro remove same upon notice (rom �hi� Cily and lo replace oll <br />public property domo5)ed fhcreby. <br />� <br />Inspeclor's Signafurc <br />� <br />. -�irr�' C.��c,� � ,� ��'i!>�ii <br />Dale <br />Remark: <br />f�l � ��_ _ <br />_.,_ <br />Variance Requiicd <br />Ycs . _ . .. ._.. <br />No. . ...... <br />��'� � k,�.�� s�, �asrr�r �v <br />���Y1S���� � , <br />r /! rC�✓�i'i/,:'_; < sr—. <br />� $ignalure of Applicanf <br />/� / P <br />r S�e� � : �< �', ,:%r, . /� <br />—T' � � Address <br />lelephone Number <br />'/ Hi �. � �+/% <br />Y,.., <br />�0�9 <br />s 0 GE� <br />Fee <br />DEPT. PPROVALS <br />) <br />Enginceis ��� - � �/ � <br />� Walcr �'�. ... . � r .� �/ � "7/ <br />,�,. ,. � <br />, , <br />Slrcet __.: �•�� :.. <br />�( " ,--_.--____._— <br />
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