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EVERET7, WASH. <br />The Undersigned - <br />Hereby applies io; permission <br />At fhe {ollowing <br />SKETCH <br />(Wnrk to be donel <br />The undercigned owner hereby agrees to hold and sovc harmless Ihe C��ty of <br />Everelf from any and all claims for damagez that moy arise because o( Ihe <br />installation and maintenance o( ihe improvemenl hcreto applied for and <br />(uriher agrees to remove same upon nolice lroin Ihe Cily and to reploce all <br />public proper�y damaged �hereby. <br />Inspecfor's Signalure <br />TiTr �r/�GiK -i� �%-;��'%/ <br />Dafe <br />f,a!I Engineering Dept. 259 d8!':; ' NOTE � <br />24 Hours before CHCCK �vI7H WATER <br />construCtion is slarte9. DEPT. FOR W�TER �INE <br />IOC�TIO�:S BEF(3RE [XCAVATION ) <br />Approved By <br />i�Pl-j� .G <br />Dalc Apploved <br />/ <br />Variance Required <br />Ycs . . . . .... <br />No. . . . ..... <br />��( L�L� :�;� ��(�,l�//v <br />� � /, / <br />Signalure ol Applicanf <br />�� � � <br />� � S i c �-e.� � " }�� � <br />'i �'Vr <br />Addr ss <br />`z�'�- /`/�'b 3 <br />ielephonc Number <br />Dale <br />$ l�r ;' l� %_ ; �_ : <br />Fee <br />DEPT. APPROVALS <br />/ <br />�/" gi, . / <br />Enginccr5,''� �" �— <br />�1;;� ..i�.i. %'I �''1 / <br />ti Wa1cr <br />Slrccl <br />� � t•. , . a.: <br />Communicalions �c- ' ' �� %� � ' ' ` <br />Tra(fic <br />Planning �` �' ��� — <br />� PROVIDE FOR <br />PIiOPER DRAINAGE <br />