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CITY [' lt•II ICG:S <br />EVERETT, WASH. <br />Approved By <br />— L�fZ-'L�i4/-7'� /�C? �7 Y.ii <br />The Undersinned . i ) c�' ,[ i���) l<�I r� Daie Approved <br />Herebyappliesforpermissionto (i.nu�•' O l�ri�_� --:�/-�.,;•v�•f� '�,�<<v'nI�J <br />Af the following locaticn %�� l•� � i�F� r I�� h,�v� <br />SKETCH <br />IWork fo be donel <br />o�vY -�:,, <br />� ��\ <br />� <br />���'o <br />�h� <br />t� <br />F'� � <br />The undersigned ownen c�reby agrees to hold and save harmless Ihc City of <br />Fverett from any ond all claims for damages Ihal may arise because of the <br />installation and maintenance of Ihe improvement hereto applicd ior and <br />further agrees to remove same upon nolice from Ihe City ond to replace all <br />public property damaged thereby. <br />Inspeclor's Signafure <br />.5':r� C.s�.c',rr�� ��/4�7� <br />Dale <br />r�;, 1r <br />Variance Requirec <br />Ycs <br />No <br />c� <br />� r , .l.t ._ ,.:.I.i �. '-''i.t�--Q <br />,� Signalure of Applicanl <br />�.r�' / � /.S !Y'(7Pl• /u fS�v� <br />Address <br />.�s3- 22.5'�. <br />Telephone Number <br />��.-II- 7L <br />oa�e <br />$ il?� �e e <br />Fce <br />DEP . APeROV 6 • <br />Enginecrs �. �( y1��,� ��z/��/7� <br />Water � .-.,.+- `r' �.' / 4 - 7'Z— <br />Slrcer — . _. . . .—._- ------ <br />Communicalions - -�- ��Ti�� <br />Tm(fit `��' j`i� v 2-� " I 2 . <br />Planning ��S • 2 - /�/' 7 z- <br />I , ' �'j E �: , <br />L,I':l,4�Il�� �;A'ICR <br />� � ;C�l. LOCli?�,��R 1��4TLR ll:��';- � <br />. r. . �_..___ . <br />� , ... . ... _...r_� <br />