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EVERETT, WASH. nPP�o��d ey <br />N�vEM/3F:F'. /,/ /�f'%/ <br />�� � �� 12E F f.l li�! lJ r: /J Dale Approved <br />The Undersigned��JF:L. — <br />1 � r � r.�,._ .� t..�.. � a"".I'r� i.Jl.:� ji !�'' <br />Hereby applies for permis:ion fo ,� �� - <br />At the following locaticn � ��` �� � �� ! =•L'-"'`! — — <br />SKETCH I F-� <br />(Wo�kTo be d"one7-- ---- � <br />BEV�R�`( <br />LA��� <br />The undersigned owner hereby agmes lo hold ond save I:armless the City of Variancc Required <br />Everett from ony and all daims for damages thaf may arise 6ecause of the Yes .. <br />_... ._ __...._... <br />inslallation and mainlenancc of the impro�ement hereto applied for ond <br />further agrees to remove same upon nofice from the Cily and to replace all No ._.._.___..._...._. <br />public property damaged Ihercby. <br />Inspector's Signature <br />�S/T� CNEC�CE/� ��i�7/ <br />Dale <br />�`�E �/�.'?C✓C�1'/i%N: <br />I PROVID�� FUf' <br />iPRO;'ER D�i,',i�;;�,1:= <br />I <br />i <br />P�OTc <br />CI IECK 1:�1'fH 1;�ATF.R <br />D�PT. FOR VdATER LINE <br />�� n..; ,-,;1-1 Fl c,.;� <br />� r i �i <br />,� i.l-�,.C�:�<<��„ti < _ .����.�-�;�- <br />T' Signalure of Applicanf / <br />' ,� I � �""l�C_.— _. L._ . .�w. �T <br />Address <br />. ,3�-3- 7i a 9 <br />� Tclephone Number <br />Dafe <br />s �IiO F��= <br />Fee <br />DEPi. PPROVALS <br />7 <br />Engineers,� <br />Water �_'i .'i ..,�. 7`� 1- ��- 7 1 <br />sneet <br />Communication� � f _� ' - - — <br />� <br />Tmffic r-.; <'- <br />Planning 2 N 5 <br />Ca!I Fn�ire��i���;� DnpL 2;i9�;'801 <br />�. . <br />:.� i:,u,s b°fure <br />LOCATIONS f3EFORF. EXGAVATI[1N constructiun is starfe�l, <br />