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EVERF.Tf; WASH. Approved e� <br /> .�c!..-y-� /�, ` <br /> The Ur,dersigned F-��+J G� r"7 F-���''�Y� � ` Dote Approved <br /> /� i � <br /> Hereoy applies for pennission to ( -���1��'� `�� � ���• ���--`'�-� ���f�� <br /> ���� .�J � /r>� '�t •:���I <br /> At the following location �' i r --=y^� f= <br /> SKETCH <br /> (Work to be done) <br /> 3,2 �y� S TFi'E�T � <br /> _�. �j i <br /> � i � <br /> io n � ) <br /> V <br /> 19.� � �-� <br /> �, a 4�� <br /> 9 �- ^;, I " <br /> 1� <br /> � P/CKET � � \ <br /> ��1 - - - -I o <br /> �.`�-� �Z 3 I 2 ! I � <br /> ' ---�— T�, - - . _�� I <br /> MAk �/2 ' N �/E�`:'� '��✓ i� � <br /> � ��� �� <br /> The undersigned ownen c�reby agrees to hold and save harmless the Cify of Variance Required <br /> Everett irom any and all daims (or damages Ihat may nrise because of ihe . <br /> Yes _. _.. .. ....... ._... <br /> installalion and maintenance of 1he improvement hereto applied for and No.. .. <br /> _ ._.............. <br /> .`urlher agrees to remove same upon nolice from the City and to replace all <br /> public property damaged thcreby. <br /> ��..� / <br /> i /y"�.r^�.+� :`� .lr �...-:r:`� s•w.:;.�a_.o.i��t.,' <br /> —p � $ignalure of Applicanf'� <br /> \���'� " ' 's-<�?''J '} .`7 L'"'C-� <br /> �- ' Address <br /> :;��. ��_ 1��.,� � <br /> - ielephonc Numbcr <br /> Dale <br /> Inspecfor's Signolure � <br /> Fce <br /> c,���. ;� <br /> Dafe <br /> DEPT. APPROVALS <br /> Remarks Engincc�s <br /> i <br /> Watcr_—�--�� <br /> ;, . �- � �1r� rie- %oil % � ..� ' Streef—._ <br /> Commuucationz � <br /> �. iraifie ���� S;.•%e^u';�/!= e%'��ia.;et" - i;tp1' /'�f..'.;:.-��. � <br /> � - . i , ��i /=`i� _ ; �.- Planning . <br />