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5721 BROADWAY 2016-01-01 MF Import
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5721 BROADWAY 2016-01-01 MF Import
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Last modified
1/24/2017 9:13:17 AM
Creation date
1/24/2017 9:13:09 AM
Metadata
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Template:
Address Document
Street Name
BROADWAY
Street Number
5721
Imported From Microfiche
Yes
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At ihe folloaing location - ____�_ . <br /> SKETCH <br /> (Work to be donel BROA D wA y ��� _ _. <br /> / " a `SD <br /> a• <br /> g' �a� onic. o�ei vE <br /> - � —-- � <br /> � vo a <br /> � eo, <br /> I <br /> � <br /> � <br /> � <br /> � 57 <br /> I � 2 � <br /> i <br /> i <br /> , I <br /> � <br /> � <br /> � <br /> i <br /> � . <br /> � <br /> � <br /> I I <br /> I � I <br /> I <br /> ,, <br /> The undersigned owner hereby agrees to hold and save harmlezs the City of Variance Req�ired <br /> Everett from any ond all cloims for damages that may arise because of the Yes <br /> inztallation and maintenonce o( the improvement herelo applied ior and -�- -�-�������� ���-�-�"' <br /> further agrees ro remove same upon notice from the Cily and fo replace vll No_.__. _.__. ..... ... <br /> public property damaged thereby. <br /> 1 r ' ` ; I\ �, I (` �. t <br /> j�. � (���'� �✓ W q ct IJ=� � N��ot'e �(a���.q col.cvc c_ � <br /> , ",� r': .��C[/ ._�G..�� , .� ,.!/(1A.(�i'y.N� �?c' a�,�, <br /> "�2/ ']L �/L'� /��[�.C� �-(--�5 rt Signafure of Applimnl � <br /> [" it;, i/f.�'-` ,., <br /> �/ �/ - �' � �1� � / ��«--,-v/«,-.i <br /> add,et, , i <br /> -�� : , �� s-5- _ ., -,��� :� <br /> Telephone iJr•�ber <br /> �S - / � - 7 �` <br /> Dafe <br /> Inspeclor's Signalure s Y i <br /> � so �i � �, .;cr. <br /> / 1J- �0.?¢ � <br /> S/7L� C Jir�/ '. ��� �//7c'J Fee <br /> Dafe <br /> DEPT. APPROVALS � <br /> Remarki ` � <br /> Engi neer�7`.�2���s.`�.Z�C_ <br /> X Waler � //(i"-'• ' ' <br /> Streel <br /> C:-runications � <br /> Tm(fic Ti= l'3�s-._.-, -��;��_ � <br /> — . . Planning / � � _ � <br /> 5 r�nI c; CLt'I- ;�� , <br /> Y'�� , <br />
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