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� APPLICATION FUK UKIYCY�/� � � �•-• • • 1 v J <br /> �--/ <br /> �1 \�--____--- <br /> CITY ENGINEER$ pp�oved ey <br /> EVERETf, WASH. rh TOb �r � i4�4 <br /> �� `/1 Date Approved <br /> � ;s. t_..1 ..�d r:rLt.�' <br /> The Undersigned � � � l , <br /> i . :./�l � ✓S� ��__ <br /> Hereby applies for permission To <br /> (�G � , I�' <br /> -- Zi F . <br /> At the following location <br /> SKETCH <br /> IWork to be donel <br /> -f, <br /> ;�',a <br /> ��': <br /> 4 <br /> /�. <br /> Variance Required <br /> Yes._.. <br /> The undersigned owner hereby agrees lo hold and zave harmless the City o No. _ _.�_._..-.�-..---� <br /> Everett from any and all claims for damages thaf may arise be<ause of the <br /> installation and mairtenance oi the improvement herefo applied for and <br /> further agrees ro remove same upon notice from the City and ro replace all <br /> public property domoged thereby. <br /> .. , . A' �/� o/ � $ignofure of AAPiicanf <br /> � e � <br /> a<'x z.�;� <1 -� , r'l� <br /> ��� add�e,t <br /> __-- <br /> � 7elephone Number <br /> — Dafe <br /> � <br /> � � .��"., a <br /> Inspeclor'; ignature Fee <br /> o ���y <br /> Date DEPT. APPROVAlS <br /> 1 / ' <br /> Engineers �p <br /> Remorks Water � ' . __,_ <br /> Sireet � , � � � <br /> - <br /> —_---�-- �._.._ ._�....,�._.-,._ _ __ . .. <br /> �-- <br />