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[VERETT, WASH. <br />?he Undersigned <br />Approved By <br />_�-=K�r���' ,c3/97i <br />Dale Approved <br />r, �' � �� / <br />Hereby applies for per•.ission to �'��''` �� ' � , � ' �' ' - ' - — <br />At the following location c G�— �'i {� D I'- �' "� - <br />SKETCH <br />IWork to be done) <br />w �. <br />,_ , <br />�� <br />. � �„ ��; <br />� > ;� � i:: <br />#� '` <br />The undersigned owner here6y acrees lo hold and sa��e harnless the Cify of <br />Everelt from any and all claims for damages Ihat may� arise because of fhe <br />iastallation and rnaintenancc of t�i� improvemenl herr.to applied for �ond <br />fu:ther agrees to remove same upon ndice from the Cii, an�: to replace all <br />public property damoged thereby. <br />Signafure <br />�SirE C�v�crt�� �z/2�� <br />Date <br />,c7O'J � 3?il6"/ ) <br />�� - <br />I <br />.. ��,,,� , <br />CHECr< �yI7H IaJflTEfi � <br />DEPT �OR IVF�TER UfJE <br />� �'� ��`1� REFORF. FXCAVATlU�1 <br />.,._'-� �"�„=-�..�..�.--__._..._...�__._ <br />Variance Required <br />Ycs.__. __....__..._..... <br />No....... _. _........... _... <br />F. 0. �0�1�� <br />� <br />������� , <br />u ,�'au.�c`— <br />Signalure of Applic�nf <br />�' <br />�7 n 3 � neh-c,2'�� ;? ,,� <br />Address <br />Z� z 76d�9 <br />Telephone Number <br />> `-: i2 - 7- �/ <br />Dale <br />� c�� �ii�:IlWlllll�' U' �i( ,_'J�'U,��3 <br />24 keurs tefore <br />n,�nr,ir.:�r-,n ic :�[::���-� <br />4 <br />_s J���� F�=f - — <br />Fce <br />EP �APPR� <br />` iz�'L�j <br />Engineers <br />�?� `Nater_ �c'�+.t�:E"+`'., t s - ) ? - ^r <br />$treet �: <br />.m�. �- ./'� .: 7_. <br />Communicalions � , <br />TraFfic r �� .%�� �� —` � i /a �' Y; ." <br />Planning � �'� = - <br />., � n �i._:��.�cqr. �-- - . . ._ .. , <br />� �'�:.v; �' . . <br />"..'.��'_.� i �i�...u',:�c ' <br />I � <br />i <br />