|
i_, i _i� �� i .__ � .. . , , .
<br /> EVERETT, WASH. Approved �y
<br /> �-Cr�G.%�if.� 7 , �
<br /> The Undersi�ned �� P FF-V `%'%! _ Date Approve �
<br /> (�r`���.r,.,.f r 7' fl� 'q. ] - � :� : :i- �'� P� .� �1. `� J/U� ��
<br /> Hereby applies for permission to
<br /> At the following location�5� 7 L oa�t 19'A a � —
<br /> SKETCH
<br /> IWork to be done) //07 �� �'^`' �`
<br /> � � i� � � -- -- �l
<br /> GZ / �
<br /> Q.j.
<br /> �� I
<br /> �, ' / ii'/r%:: �,,: li
<br /> \� !� ; I �
<br /> I u� � � ' 1
<br /> �v u I
<br /> i �
<br /> i � � � �� '���
<br /> r �Z� I � i.
<br /> � � 9, : ; io ; �, �" I �
<br /> i ,8 . � � „ ! '' i-
<br /> �� � i � , ,,
<br /> I ����Fro � '� � I; �`�� , ' �(�
<br /> I i� � � N
<br /> � � nl l i � �.�`�^�� , I ,
<br /> � 69==—� �,� � � ��f---��
<br /> � � i ,
<br /> ; ;.. �;,.�
<br /> � � � ---•
<br /> i ' -
<br /> � r
<br /> i
<br /> ��-2n.5-s �;�.
<br /> -- ----.. . -- - _ _ . . . ..- � - - --- . . . ;
<br /> F,. Kys4 . - _ - _ _ . � .
<br /> _____ ___. . _._ -_ _ _.—. ... ..t �a-\ _. _ . _ . _. . _. . .
<br /> LO{�-1�ARp — -- ..^. v C .
<br /> The undcrsigned owner hereby agrecs fo hold and savr hormless the City of Vcriancc Required
<br /> Everelt from any and all claims for damages that may arisr. ber.ause of the Yes.. . .___.__. .
<br /> insiallation and maiNenance of the improvement hereto applied for and -t�- No. ..
<br /> fvrther agrees Io remove same upon nofice irom Ihe City and lo replace all �{�) <"i ?. � � �-� -��-�� -----�
<br /> public property damaged thereby.
<br /> .__.,_...__. . . . ___ .
<br /> 1litlV /,,,:.�/ � SF.L'Y10N ,__^� --�
<br /> (i.l: . 3C:?LE) . .___. _ . -�::�, .'.",'a' . . •��ili,i.,f . i � , .
<br /> j i9, � �.� �.
<br /> � , �.'�� � �U.�l • G' �'c< <��tr,
<br /> � ... —
<br /> �-�-�"2 2 �---� E Si nalure of Applicanl
<br /> ✓ � �'%F/rviu,e�9 /�Nc
<br /> � ':,�.< i•�
<br /> ; ut" � ��..g�' _ . I - - • `'�1, /�1 �Ysd
<br /> .._ ..,..:...... _.__.. . ....�_.� .�.... _`�"_ ..�. . . �. � -- � � ,lr[�
<br /> �, �(i St) �� �il/.) �/'
<br /> . ' 4' .. . ` , ��./�' .� {1'i�`! �� ' Address
<br /> iV.�...�._...�. --"I'-" . , �.�,. ..... ...... f..........�. ......,.__.-.-��� �.i — ,
<br /> �
<br /> ._�r � i
<br /> ;--___._�`--._._ ��z 2 ;--_ � . ���..__'._._..�_.._.� � �� �� �- �b S 5
<br /> t ielephone Number
<br /> ' __ __ /,>L! / % /%a
<br /> Dafe
<br /> Inspoclor's Signature S �� ' � �'
<br /> �,�>1%/- �f��r:�C'�L� ��s �//C,
<br /> Fce
<br /> Dafe
<br /> DEPT. APPROVALS
<br /> f =?.�
<br /> Rc�iorks Fnginccrs�
<br /> - ./' :'�, . � ���//Ci
<br /> Walcr .:i_ _
<br /> _ Sircet
<br /> ._ � � , �
<br /> i
<br /> Comm ���Y..�< 7C �
<br /> 5.� y-,
<br /> IrGiil[11�%� /' 17' ' /' 7!)
<br /> _ Planniny `" � � ! —
<br /> �-
<br /> � i I n,;i�ccring Dept. 2�9��fi13 � — _—
<br /> J' iDL F�(Z �I
<br /> - rl �trLt �Cfi��C �'� �
<br /> , � U cR DRAGVAGE !
<br /> ;+�, � ,;� is ' !: �,. '`TE �
<br /> I
<br /> �-K WITH WAfER � �
<br /> n„ �,;a,?r.R LINE
<br /> i
<br /> . . .. ,- ,�.� , I i . �--------- _.
<br />
|