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. . rr,:o�c py <br /> ��'�'if 7_'7 /� J,� <br /> !�- / - <br /> The Undersigned _ r ` = 'r"� Date App:o�ed <br /> Hereby applies for permission to � ""' �� � - = - • i i ^ r <br /> --;,r:-- ,��' �- !� i i; _ � . . .. . <br /> i'I <br /> At the following lowtion l 7/ .4 — ' _ ` . r= <br /> SKETCH <br /> (Work to be done) <br /> ' . ,. . - . ."HC6?� l� Y i� ._ . <br /> -LK ncw c•nzo•sicc�vn-K <br /> L"C�NCRCTC e,T pfjN <br /> _ _ . _ - . _--__ _ . . _ r <br /> - '.', .�-. _ . . <br /> __--- �• <br /> I __ ��:1d� _ � <br /> I _ - F ` - . <br /> '' _ <br /> 1 <br /> I <br /> � , ti v v n � <br /> i,�=No� <br /> j �—�� <br /> �';'I i <br /> i . i �" <br /> I i� � <br /> I I � " � { <br /> — -- - — — - -- --- <br /> _ -- - — <br /> ALLE �' <br /> Thc undersigned ownen c�reby agmes lo held and save harmless the City of Variance Required <br /> Everetf from any and all cloims for domnges thal may ari:e because of the Y�= <br /> installaiion and mointenancc o( thc improvement herero applied for and ���-�--�- �-����-� <br /> r r._�� Na <br /> furlher agrees to remove same vpon notice (rom the �ity and fo replace all .3 V i1 �. � � - ---- � �- <br /> public property damaged thereby. <br /> ,O.�1YFl<'/1Y: SECTIt11J .:_ � . ��,: .: •�`;. -SaCTtON � , <br /> i <br /> �, �': ;n c_R!:� .�j.. �.-.'� /��.�_�.. <br /> �---�' . . %' • <br /> �='.-��-'--� ��' �Signalure ol Applimnf <br /> .. -'_.-- - — —"—: <br /> ..�_. _ <br /> �_ � � _.. . . . __.--- - ,. � .. <br /> �1� � - . �.�0� o i�I I'��"] �� . - �i:r.,.� ' <br /> __.._ �,. ____, _...._� Addresf- <_ 1 <br /> ()t• r.��� . .. . � �..� . �' <br /> !-.� ... .....,-. ..... E�... . . �. , i- / � .-/ .'C^ / <br /> � ' ' � -�' �1 <br /> . �_` _ (n!(� .$ G6�� � � ielephone Number <br /> . _ .__.-_-------_'•----. 3�7/J� <br /> �—i <br /> Date <br /> Inspedori Signalure $ � � �,�!� ,3 /7/7/ <br /> SiT�: C�;'G�;ti'i�.�) 3/7..1j/ '7/ Fee <br /> Dale <br /> 1�C,�/!/iy �C��'�I �C�i�'�L�i�i�L/� �/f��FilJ //1%Si�.f�'s'7'()'� DEPT. �PPROVALS <br /> Remarkt ��� ._ f j/�O/T/ <br /> Engineenli��" ���_ � <br /> ��5� �i/��.t� Woler��t,,•..., 4_� n �-7� <br /> Slrecl_� � <br /> Communiealion}, �7f:j�:`�"" ,�-'�`. �e.:-'"- - <br /> Trof(ic �'��' '� •� . <br /> Planning i/-�i' <br /> �'��OVIDE FOR � � ��;t`TE <br /> Call En�;incering bept. 159��;;p; ; ;��pF_R DRAINAGE � � �_::r ����IiF� �vn,�rr, <br />� 24 Hours betore ��. !'��. r=,�R wA�i�ER Lir.r <br /> construction is started. I t�����Ti;)NS BEFORE [XCAVATI�Jr� <br /> I .� <br />