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EVERETT, WASH. Approved By
<br /> The Undersigned � ' Dore Appro�ed
<br /> Hereby applies for permi;sion to - '`r '--`' ,'�'-.. - `� , � `= , ' � .-
<br /> At the following lomtion -` - � - _ T��f��✓ �� ���.' 1��n i i �r �
<br /> SKETCH I I I
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<br /> The undcrsigned owncn c�reby agrees �o hold and save harmless 1he City of Voriance Req�ired
<br /> Everett (rom any ond all claims for domages thal may arise becouse of Ihe '������� Yes. .. ._.. . _.. .
<br /> inslallation ond maintenance of the improvement herefo applied ior and No . .. . _
<br /> furlher agrees to remove same upon nolice from the Cily and to reploce all
<br /> public proper�y damaged Ihereby.
<br /> �� ''. �J.a. �17�ah.,e�� _ CC��.�<<..tii _
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<br /> ��' 13�dr� � Address
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<br /> Inspedoi s Signofure $ /v Q J=%: `�
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<br /> Date
<br /> DEPT. APPROVALS
<br /> Remark� Engineers�
<br /> �- Water -'�f �
<br /> Strcet
<br /> Commumcalio .:�-1-�'i_� ,-�_-'� � �� -— � -
<br /> Tmffic_�='`-._J-,' / _...
<br /> Planning F/�r{ .
<br /> �ji,r '%i ;` r �/lll.�.r( �(li.a; �
<br /> Call Engineering Dept. 259•8603 --�
<br /> 24 Hours before � PROVIDE FOR
<br /> construction is started. ' i'�:OFER DRAINAGE ` NOTE
<br /> � cr+r_cK �virF+ �;JnTrR
<br /> � tirP7. !uR 1'��1T(R LIN['
<br /> i_�� � i��� , ��� ��'PC EXri,VATIGN
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