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EVERETf, WASH. <br />. . � / l � � / /.� / <br />n�P�a��a eY <br />/—r's3.�c/sai��,?f^ /�%c' <br />The Undersigned�� H^1 iT i-% i�11� L F V Da�c Approved <br />Hereby applies for permission to r'aNS'T. A C i T�/ STAN S�(.tJ <br />Af the following location 78�z— �� L- l/ � 1_ L�U. <br />SKETCH <br />IWork to be donel <br />„ <br />- [.o' <br />s�.v�R��r <br />The undcrsigned ownen c�reby agrees to hold and savc haimless thc Cily of <br />Everetf from any and all claims lor damages Ihat may arise because of Ihe <br />installotion and mainlenance o( Ihe improvement herelo applied (or and <br />furlher agrees to remove same upon notice from the City and to replace oll <br />public properly damaged Ihereby. <br />�Vr �"/- � "'$�?`�.c.:_ _ .....__. �.�.�.. j•,-�' � r �` <br />(K TD /�Gt�i�_ ��✓[:` l�,i;� K <br />/1 i 7Ni � i�;�•, . _ <br />�� <br />Inspeclor's Signafure <br />_ Sir�£ �.�/_FG'.tic-i� z��S�.L <br />Dale <br />i��'J� �� � �.'ii'.. �� � iti-ii�3Q� <br />� ,�„�dl: 6.!:i{C <br />ir�i�:�t IS Sid110t{. <br />�—''i�:� <br />; ' , .r� fr� 1'',�J'f'R <br />'� rr' ;`i, FC';t'i:'�Tlfl LIF:F <br />\ ioc.n;;��::s � _rorr: rx,c.avnrror� , <br />BLVD. <br />Variance Required <br />1"es <br />No <br />�-r.� �� <br />�,�N r. Niu�LEf' <br />Signalure of Applicanf <br />78�z- r.�� v, �� u�v. <br />ada«,� <br />3S 3— 78Z 3 <br />Tclephonc Num6cr <br />�_/c�_ �Z <br />Dale <br />g n!c FCC�= <br />Fcc <br />�� `� <br />DEP A�fPP''ROVALS.. <br />Engineers ��l—r/R�[��'��7�7?L <br />Water . . <br />Slrcet <br />Cammunicolions � � � <br />Traffic - -- <br />Planning �� ' <br />