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EVERET7, VJASH. Appro+ed ey
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<br /> The Undersigned �� ✓�"� � -r' �f �+ Da�e Approved
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<br /> Hereby applies for permission to , , , � – r —
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<br /> At the following location'_�t–/�'�_,[� � � ,c+i l'� -i �/j�-� ��'��!`/r' �(!� '•`.—'f r-f1�'�'��
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<br /> IWork to be donel
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<br /> The undcrsigned ownen c�reby agrees lo hold and save harmless Ihe City of Variancc Required
<br /> Everett (rom arty and all da�mz for damoges ihat may arise because of the Ycs . . ... . _
<br /> inztollation and mainlenance of the im;�rovement here�o applied for a.id No _ .._..
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<br /> further agrees to rernove some upon notice from the City and to reploce nll
<br /> public properly damaged fhereby. .,
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<br /> Signalure o( Ap�'licanl
<br /> �1� P��Q�- �. 1'1 -L- :..1 C_-� fJ q�
<br /> 1'.L � \� �1`)�L � l.'IN�JW'�OG
<br /> Addmss
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<br /> Telephone Number
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<br /> Dale
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<br /> Inspecfor's�-8lpnalure .,> ;
<br /> ;' Fee
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<br /> Dale�
<br /> DEPT. APPROVALS
<br /> Rema�ks Engineers �
<br /> Wa1er ' - �'r � � �'
<br /> _ Streel � �iw �" �.+ ' �
<br /> Communicalions
<br /> Traffic
<br /> _ Planning
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