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, ---- - - <br />� <br />._; i T,� � �— <br />The undersigned owncn c�re6y agrces to hold and save harmless ihe Cily of <br />Everett from any and all claims for damages thal moy arise because of ihe <br />installation and maintenance of Ihe improvemenl hcrclo applied for and <br />furfher ogrees to remove same upon notice lrom Ihe City and fo replace all <br />public property damaged thereby. <br />Inspeclor's $ignafure <br />STt�: <.r�F_r'.�.�'i� `�� l �7/ <br />Dafe <br />�(���.aM <br />Czll Cngineering Dept. 259 8803 " NOTE <br />24 Hours before CHECK WITH �1�ATER <br />COnStNC1i0f1 IS St2ftcd. DEPT. FOR NJATER I.IN= <br />LOCATIONS �EFORE EXCAVATI(�V <br />Variance Required <br />Yes..............._.......... <br />No................_.__.. <br />'� <br />/�� : �,, u b.. ,,,��,. <br />c` Signafure of Applicant <br />'�a � � C�/<<; �7 l.r,� . <br />Address <br />� S ? - ��. � �. <br />ielephone Number <br />���1 �9 ��r / ;` _ , ;� � i <br />Dale <br />L <br />$ �� �'�/� <br />� <br />Fee <br />DEPT. <br />Waler �; / ��-..�: c =.'- -f %l <br />Sirecl � <br />Comm - _- ___ � "'�""�o _ � <br />Traffic <br />Planning � �{� <br />PriOVID FE pR <br />PROPER DRAINAGE <br />