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<br /> EVERETT, WASH. ��roved ey
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<br /> The Unclersigned r��'— - — '4'-� - � �'` '\���G'i.` _ / ' G � r �r' Date Approved
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<br /> Hereby applies for permission to�fS� �iUV� �r�'� F'' s`r,�J��„�,'/ (" �, �j'� '�+-�� ' ���'
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<br /> At the lollowing lomtion-3 ��l ' ��i L/S✓�
<br /> SKETCH ��
<br /> IWork to be do el
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<br /> 38 T" ST�EET- �"
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<br /> The undersigned owncr hereby agrces Io hold and save harmless the City of Variance Required
<br /> Everctt from any and all claims for damoges tha� moy arise because oi Ihe Yes.__. ..__._. ..
<br /> installation and maintenoncc of the improvemenl hereto applied for and No �-��"'
<br /> (urther agrees to remo�e same upon nofice from the City and to replace all - - ---�
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<br /> public property damaged Ihereby.
<br /> �1/OTE; T'/�F ,qSPH/�L 7- SIQEWALK�ALLEY
<br /> �RE ;�,,.;���,�,�,ey �;a-,���,—U,��,�d�rG, ,,. <. 4_ � ,) � �
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<br /> ,4Nia Ci.-Y s;;di/v�',t'� CaNG Cv.2(3 .'C1 ��E' /NST,��[.c-,� ��c s-�//J:��/ _��, `
<br /> f,r �'()��LG'� G�l��"�GC" ��[/C'n/ ��7���� , �; �^�,r�,;t������e� Signalure o/ Applicanf
<br /> ' NOTE �n1 f�� �%/ /P z� _
<br /> (.'iICCK l4�ITH WATER `y "' �
<br /> � "T. �(`i; `�L4TFR � !/�{'n' Address
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<br /> f'�4Yi�yG l l . 7 �J �i l�
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<br /> Telephone Plumber
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<br /> ���f�p r—o�> , -� c��l c,,�•� ;;'<-:G �_�/2�7�
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<br /> _?j'21_�70 �%i�. d`e� �v>t�9�r�, .. Dale
<br /> Inspecfor's Signalure �%/�j��j'7(, �� � $
<br /> (n�(n/!u G'C'��tt,��� ��. .,
<br /> �JFLD �r'�'�Fi� -3��5 70 Fee
<br /> Dole
<br /> DEPi. APPROVALS
<br /> Remarks " .j � /
<br /> Enginccrf,^�� ��� ��%3/7[)
<br /> Walcr � �
<br /> Strecf
<br /> Communitations� � �
<br /> i..�
<br /> Traffic '/ -
<br /> Planning
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