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EVERETf, WASH. <br />P.pproved By <br />The Undersigned %�-`' ' = �°J � L : ��.� Da�e Approved <br />Herebyappliesforpermissionto-��✓STA4- �%Z���/�;;�! ' ��--%!/��-'F<' 'c%IGG� Oil C�T�/ �'/?-1f-:�.��% <br />2' �N�l� �:'� SiarG/A�,c� .4Ail� iNsz4GL � 2S UJ�e� /.'�. can/ci��"7r .:'��1. <br />At the following location �� O"? B1�j:�1.�ii_ ��/ <br />� <br />SKETCH <br />(Work to be done) <br />25TH sT <br />2'Ba=K o� s,c�wa�x <br />REQU6� T pL�2N1/SS/O�(/ TG <br />�Nsrsic � �z "Ni�.v c.<fs1„� <br />ci�/a r-��.'c� <br />s�D� <br />,�f <br />c �,J` � BLK 567 <br />a <br />v <br />V <br />J, <br />The undersigned owner hereby agrees to hold and save harmless the City of <br />Evcretl from any and all daims for damages Ihat mn�� �rise because of the <br />installation and mainlenane• of the improvemrnl hercto applied for an� <br />1urlher agrees to remove same upon notice from the Cily ond ro replace all <br />public properly damaged thereby. n � <br />{ � <br />l, n �� <br />� �� <br />P� <br />�� ��a�� <br />;�L� <br />� �`� <br />Inspecfor't $ignafure <br />Date <br />Remarks <br />�- <br />�. 1�� � <br />N ��� <br />� �I� <br />/H'ST•4tL 2.s 'C�J�Oc /�?G, G.��:c__ G�: ;✓� '�;ii / <br />zs� <br />30 <br />29 <br />28 <br />Variance Required <br />Ycs <br />No <br />� r �9 � <br />J. {'�Hll_ �NAL�i"�t::� <br />/ / �� ` <br />� <br />� -�,� ' }_1 � �. <br />Signolure of Applimnf <br />z�_._., �,:�:�;, ,,l �,. <br />Address <br />�� Telephone Number <br />�p� Dale <br />T r,'�:`� t� � r i <br />S /� .2s D/,�•_ � <br />Fee �1 _ ' c` ," ; j . <br />, � <br />DEPT. APPROVALS <br />Engineen <br />Waler <br />Slrcel � <br />Comm..� mtions <br />Traffic_ <br />Planning <br />