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�IIl' rIJGINrEkS / �i � <br />' '—Z��'U1 _.*� <br />' EVEREI7, WASH. Approved ey <br />�i�i?/L .� ��7� <br />The Undersi ned_ ��' �''1� ��'��J�,���."�' Dai� Appro�ed <br />9 � - <br />Hereby applies for permission to �--^/ r i ' J : � '� �' ", `� ,/= l - ,"i,i:�r-�_ , /i -,'r ��l :�.� <br />At fhe foliowing <br />SKETCH <br />(Work to be donel <br />, �, -' s?F <br />�� � �.�, _ � �.v.L_ <br />�.. -- __. ,., <br />Thc undcrsigned owncr hereby agrces to hold and savc harmiess �he City of Variancc Required <br />E�erell from any and all claims for damages that may arize because o( Ihe Yes . .. ._.. <br />instnllo`ion and mainlenance o( the improvement hcrelo applicd (or and No . <br />further agrees to remove same upon nolice from the City and ro replace all -�� <br />pu6lic property damaged thereby. <br />r)�)��.j <br />Inspeclor's Signature <br />.,� T.s N_F.!_'.�i� � .��� - %I <br />Dafe <br />i <br />� �.�..� ";/.! ��..��f: »:,��• <br />�.. <br />Signalure ol Applicanf <br />i' % <br />i i / j' .r �.r,.. _.''; .�f / ". • r <br />— aad«,: <br />•" 4- :j , p ) : . . . <br />� J �� <br />Telephone Number <br />Enginecrs <br />� Walcr— <br />� Strcef — <br />i <br />� Comv�uni� <br />Traf(ic _ <br />Planning . <br />--- ;�. / ' � � � <br />Dafe <br />s p( t; I� r- �:: �. <br />Fce <br />'i. APPROVALS <br />i� � <br />�1.� � '��a�7, <br />�_ <br />`� . 7/ <br />�� <br />� -- <br />' �tOTE <br />;f+rci< wirE� wnree <br />:,_:,;�, rn�; �1mF�� i.itv[ <br />,�r��:'; [3!'�i7�� t-xr�VATION' <br />