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EVERETT, WASH. <br />The Undersigned <br />Hereby applies ior permission <br />At the following location_ <br />SKETCH <br />(Work to be donel <br />I" <br />/ <br />\ <br />\ <br />hi <br />�� <br />rn y <br />�' <br />��� <br />t, <br />t '� <br />/ \\ <br />I J <br />� � � �I V � <br />/ ` . <br />� • � <br />/^.��o G <br />r '� � <br />�r C�cti�i � �C ; <br />2 <br />., <br />, <br />., <br />, � � � , � . � h p <br />__�J G . <br />The undenigned owner hereby agrees lo hold and �ave harmles: the Cily o( <br />Evercll �rom ony and oll cloims for damages Ihaf may arise because ol the <br />installation and moinlenonce of the improvemenl herelo applied (or and <br />(�rther agrees to remove same upon nolice irom the Cily and to replace all <br />public proprrly domnged Ihereby. <br />( �ll � C 4C C lf .• ��"/��� <br />��f/ . �G< � <br />. __' - , < � <br />�"tt .�-�, _ < -�r �..,� .0 � - <br />Impeclw i 5� lura . <br />� <br />� <br />> , �' � <br />� �. <br />Dals <br />0 <br />��" <br />C�1 <br />C� <br />r' <br />�L <br />pproved By <br />1'�nL I1Z,14.�.,� <br />--TDale Approved <br />Variance Required <br />Yes <br />No <br />�. ' /i <br />; / -� ��C�l `/ ' � • !/.". , ' •�,, <br />$ignalure o/ Appficon <br />Addrets <br />Telephone Number <br />oa�a � <br />S <br />F� <br />DEPT. APPROVALS <br />Engineers <br />Woler v <br />Streel <br />Communicationsi.-.. �' ��' . <br />Traffic _ <br />Planning — <br />