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126 MADISON ST 2016-01-01 MF Import
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126 MADISON ST 2016-01-01 MF Import
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Last modified
4/10/2017 10:07:43 PM
Creation date
2/17/2017 9:46:39 PM
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Template:
Address Document
Street Name
MADISON ST
Street Number
126
Imported From Microfiche
Yes
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EVERETT, WASH. <br />Approved By <br />Y � <br />� i /'/;�/i3.�'i2 %� � _ <br />The Undersigned �-• ��� — K� N N F- •`[ �ate Approved <br />Hereby applies for permission to�1`�d1�-�7 /� i' l i y �� AN l: A2 D S/!�f/ <br />At th:: following location � Z � � �%� �/-� �/�� -� � — <br />SKETCH <br />(�York to be donel <br />T <br />� . <br />if Ol <br />I -= � <br />The undersigned owncr hereby ogrees t� hold and save harmless ihe City of <br />Evereft from any and all claims for damuges thal may orise because of the <br />instollalion ond moinlenonce of the improvement herefo applied (or and <br />(miher egrces lo remove same upcn notice from !he Ciry and to replace all <br />pvblic pioperty damaged themby. <br />Inspecloi s Signafure <br />. S%7�- �./�eC,f-�=% i i�/r/�; _ <br />Dafe <br />Remarks <br />NC% � 'MOVt I/✓yT.r'�; SifU% OFF �/)LI�L <br />r� v��n��oFs/w �E�e�a2.� <br />PC.N'CI �J(. GG���.:G. <br />_ _— — __---- <br />arovi�r fOR �- <br />' f'nU,"�i2 DRAIiJAGE � <br />I, <br />�..._.__- <br />� <br />� <br />��W <br />Q <br />�. <br />TYEE <br />Variance Requircd � <br />Ycs_.... _... _. _. _ _.. __. <br />No... .... _ _... _ _.... _... <br />�_� .� �i �1 / e�,' � .�,., i , i <br />Signafurn of Applimnf � <br />�_�! 1.+ /1 ! G�.:%G�a,C-rL_ .� % <br />Address <br />� %'`� 2! � <'� ���1. <br />Telephone Number <br />J� j .� G,�� z. <br />oar� <br />5 No �=F_� <br />Fee <br />DEPT. APPROVA <br />-__L�' i /i <br />Engineet5 _ � � • //� <br />wai�� .-�� 7- /L- Z <br />Street — <br />Communiculions �_'•-� �� �f -�C° "7/ <br />Tra (�ic !��-� � �- <br />Planni,�g R f-1 S <br />NOif: Call En�ic ` - , <br />Jdfl;lf; L,���',. :... . ., . <br />CI ItiC'rC N.�ITH \vilT�ft 2A Heur, hzior �,� <br />DcpT. F:�f; 1:�ATGR LIP1E CensiTuclion is startep. <br />LCC�TIC?,75 H::FORE EXCAVATION <br />
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