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/ <br /> SKETCH � / . r���f <br /> IWork to be donel � '�r 'Jj `t �,j � <br /> /� L� � � r <br /> � .,, ,, �sT <br /> � � <br /> / � �z.� � <br /> � <br /> ; j . �,Qs,� �aN�. .n,�l v�:vs�.d Y <br /> --J <br /> S'�::�'�i:�`c FOR I `' ��S (�n� <br /> FhC'':R DRAINAGE � � �'J <br /> .......--� �, <br /> � <br /> `�l <br /> � <br /> The undcrsigned owner hereby agrees lo hold ard save hormless the City of Variance Required <br /> Everetf from any and all claims for damages thot may arise because of �he <br /> Yes._.. ._..._.............. <br /> insfallation and maintenante of the irprovement herelo applied for and No_.. <br /> __.._...._..._.... <br /> furfher agrees to remove same upon nolice irom the City and to replac.. o�l <br /> public property damaged Ihe�eby. - <br /> .� ✓J / j �� � <br /> C'J �'1//� / �(t-[�t�GLlt>iRG� <br /> ;'; %� � Signafure o( Applicanf <br /> . '. � � ^ <br /> '/,`/�7 . '��'- «-.�,/<<;. .<.: <br /> ddress <br /> 1_S.z — C9S�'� <br /> ielephone N�mber <br /> �' — <br /> y ��f��..� � Dale <br /> �/1..`r,� .:� • Zi-�o�<.!� .G /,:i�� <br /> \ Ins d 1s Signalure � 5 � c �� �� _ <br /> , ;. ,6 � � , <br /> �� //� � n � Fee <br /> � _ �j' <br /> Dafe � � �27�"" <br /> DEPT. APPROVALS <br /> Remarks Engineers <br /> Water <br /> Slreet — <br /> _ r <br /> Comm���.,���. `�''`—�)��'ii; <br /> TraFfic <br /> Planning <br /> , . r .� <br /> � .� <br /> - � - <br />