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1 <br /> IWork to be donel 1 <br /> ii �--�+----, --- <br /> i� � :�: - <br /> � � ; , ,. <br /> 1 <br /> ; _____— <br /> , ; <br /> i ' <br /> ,1 oglS <br /> r _.--- <br /> I�nRPYt — <br /> 1 �'� <br /> 1._-�'�—_ � <br /> r1� I <br /> 1I <br /> i �� � � <br /> � <br /> � <br /> ��.. . _ �Z� .. <br /> .-- r <br /> _ � ;. `;�p �. -- --. . . . <br /> _ . 4 <br /> ._'��+�:'�- � � <br /> F�'1/. Il'a01�✓ /it'_f'l i- � <br /> Thc undcrsigned owncn c�reby ogrees to hold and savc harmless the Cify of Varionce Required <br /> Everett from any and all claims for damages that may arise because of the Yes <br /> inslallotion and maintenoncc of the improvemenl hereto applied for and No... . <br /> further agrees ro remove same upon notice from the City and to replace oll - ����������'����"��'��" <br /> public properly damaged Ihereby. <br /> -}UYhN.T:Y:'�_::_SRCT.lO/Q � � � . <br /> '"" (idD :'.''eCALE) � �/�., �� ,.� , <br /> ,'•,, F..:' �/C�JvI_ L,1� . <br /> Sign lure of Applicanl <br /> � ..,,.,� :'_ .. �........_ _...._ �:::�. _� { �'�G ' �-1��-=� <br /> � �� , �..... _ . ��.�_.✓c-__.._W_c_ �, i .�,-� Address <br /> ^ 'r..�_ � :' =� .(��!�i� i� <br /> t'.`_.�r. _ .__..._.;... _ R3 � l-5- t/ y' �� <br /> 1 <br /> Telephone IJumber <br /> ' ---- . � _...�...__.._ _� 9 -� � -- �/ <br /> Dale %,^ <br /> L�l i' � <br /> Inspedor's Signalure $ (y� �,,,,,... �.•,..C1. <br /> �S1Tr CNFC�CD / �9/ Fee <br /> Dale <br /> DEPT. APPROVALS <br /> / <br /> Remvrkt � Enginee a a"'"�� � <br /> Water '' �^" �"� <br /> Slreet <br /> Communicafions ok �='FJ q_ �u- -�� <br /> Traffic F�( "prl e�< �- i.._ �� <br /> Planning F�� p� <br /> ' NQT£ <br /> pROVIDE FOR C��:���: yi;rt-� �'�:,�,Ti':; <br /> Gall Engir,eering Dept. 259�8803 PRpPCR ORAINAGE `%�P'�. ruit Vd;�i[E; �iiyE <br /> 24 HourS t!a(ore ���'q�(�NS B[FOHE EXCAVAi'tOti <br /> construclion is slarictl. <br /> _, <br />