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At the following <br />SKETCH <br />IWo <br />� <br />� l��_"�'C�' f`.�'� � /�" � `% � %'i <br />The undersigr.ed owner hr.reby agrces to hold and save harmless Ihe City of <br />Everelt irom any ond all claims for damages that may arise because of Ihe <br />inslallation and maintenance of Ihe improvemenl herelo applied fcr and <br />further agrees lo removc ;ame upon notice from the City and to replace all <br />public properly �!amaged Ihereby. <br />�,GL->.-r � G � � >/C c. <br />Inspetfor't�`(gnafure �-- <br />i <br />✓`�j�/�9 <br />Dale <br />,� <br />� 5 F," C o;•fC_, D�'?; VE INc1 Y <br />Variancc Required <br />Yes........ _ .................. <br />No ............................ <br />��� <br />� �iu-Gry � <br />L � <br />„j —7 Signalure ol Applicanl <br />�t <br />� l/'�� 3 Add.tn�v.. � -tr�r <br />.--- �, <br />�S'3'= � d oZ <br />Telephone Number <br />Dale <br />v� l — �� 2��% <br />Fee <br />DEPT. APPROVALS <br />Enginecrs � <br />Water 9L�CT-�— —�� �'y <br />Streef <br />Communicaliuns , _ . <br />o�, i ,- <br />Traffic <br />Planning <br />