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H <br />i <br />HIGHL AND <br />S TAT S m <br />scAJX t" 40' <br />The undersigned owner hereby agrees to hold and save harmless the City of <br />Everett from any and all claims for damages that may arise because of the <br />installation and maintenance of the improvement hereto applied for and <br />further agrees to remove some upon notice from the City and to replace all <br />public property damaged thereby. <br />_ ....� ....�;' iv:: is—:e,Y, _ .'�.e': l e r•........ <br />Inspector's Signature <br />S/ rF �Ns C[C� a <br />Date <br />FIRWOOD <br />PL <br />,15 <br />Variance Required <br />Yes... _.. _. _................ <br />No.. _._ .__........ <br />Signature of Applicant <br />i <br />u _ Addres <br />,s ?' 4 <br />Telephone Number <br />C• <br />t <br />_ ..._....�—•-..�:,...._..: ......_�._.._._._ _ ---- Date <br />r <br />�JJ`k <br />Fee <br />DEPT. APPROVALS <br />Water c" io'"" <br />Street <br />Cbl <br />ommunications <br />Traffic <br />Planning <br />f'wVIIJE FOR <br />NpT� i'r:O. LEP, ORAlfMCr <br />call Engineering Dept. 259.8803 <br />2•' hours tiefure T. hGf7 WATER LINE <br />constri-tign is started. _ "rMIRF F`'CAV4TIiA <br />0 <br />