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Permit No. .._-.--_<^�"--�-.--.. <br /> everett <br /> APPLICATION FOR D�21VE`1/'AY PERMIT <br /> CITY ENGINEERS � � �� <br /> EVERETT, WASH. � Approved By <br /> _�EJn/.� .2f� /�Z� <br /> The Undersigned L A a t �,� ?i/L� /S Date Approved <br /> Hereby applies for permission to Co��s�: A /0 D/�d <br /> At the following locafion '� `'` �'O - ���f= �' �^;'�1 ��� ��- {i �: <br /> SKETCH <br /> IWork fo be d�ne) <br /> -- — _ <br /> � <br /> I <br /> � <br /> �' _; I ' <br /> �—�—--���-- ---�-_ -— _ _ %, <br /> I 'f __ <br /> lo I <br /> aszo i <br /> I � <br /> I � <br /> I <br /> - � io' <br /> . ... . . _ ._ _ ` <br /> � � �'<ch! PLAc�. <br /> j� ----- --- ---- � <br /> � \ <br /> �' <br /> The undersigned owner hereby agrces to hold and save harmless thc Cify of Variance Required <br /> Everett from any and all claims for damages �hat may arise because of ihe <br /> Ycs _ _ _...__.......... <br /> installation and mainlenance of the improvement hcreto applied for and <br /> furlher agrees to remove same upon notice from the Ci1y and to replace all No._____.._.__........ <br /> public propeny d�ma�d��is��y:-_:�YCTYON <br /> fc�,o S�A�E� - . .. _ <br /> � �-�;%� - � <br /> �rG�iL.,'9 "i> �f�c t�.' <br /> � �;Q:� 7a� f� �gnolure oI App imnf <br /> t �•� ` .'.i�'1'��p (�7�` tJ �!C�; i,4'�i< � <br /> �+ <br /> �, ,� Address <br /> ,,��.�._ 3��j-- y; G» <br /> -' � ' ielephone Number <br /> �• :� � �/ <br /> Dafe � <br /> r�0-�C/ <br /> Inspecfoi s Signolure S � : ' ��-�"', _� <br /> � ' Fcc <br /> _ � _ , <br />