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�VE2E'fT, WASH. <br />The Undersi�ned�� <br />Heieby a�pl�;;; for permiss��n <br />At the following location <br />SKETCH <br />IWork to be donel <br />� i"' %-�" ` _�:�-.G.'. �. <br />�.::. �� Y���� �> � <br />�;ppproved By <br />t�1 v �_n- s a�,�C <br />Da�e Approved <br />i � <br />� �, . , —a� ,� , . �; � <br />o . j; . <br />/ . . /. ... , :�. - - --i` �_ ' . �. ./ �._-.. '-- <br />7 <br />, <br />; � � <br />�'- -- <br />," - <br />/UT A D/-5 � N ,4 V E/V C..1� <br />_ _-- ---- -- ___ _ - - _ l <br />The undcrsigned owner liereby agrces ro hold and save harmle:s the City of <br />Everett f�om any �nd all claims for damages that may arise because uf the <br />inslallnlion and mainfenance of thc improvement herefo applicd for and <br />further �grees to remove same upon notice from the City and to replace all <br />public property damaged therr,by. <br />__ � -� �� � <br />..�� .Y �"Z7 _� � ��j�—•zL <br />Inspec— lo gnalure <br />/ <br />� 7:� � <br />Date <br />Remarks <br />Variance Required <br />Ycs_..__.__._.. _._... <br />No_.... .._......____.. <br />i _- <br />' _ <br />Signalure o( A{�pliceN �� <br />�!"� I ✓ i i/i,: pi `: �':��-� <br />Address <br />��<��,��z <br />Tefephone Nomber <br />�` i ���/ t ..<'- <br />— L- � ( <br />.7ate <br />5 L-i: ; �;� ;' <br />Fee <br />DEPT. APPROV:.LS <br />Engincer <br />Water �-�-P <br />� <br />Sirect <br />Communicalions �' " ����`� r' � — <br />Traffic --- -- <br />F'lar.rin� ---'- _--.----- <br />