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g�. <br />�>f':�`.�i/,'.9.t",P .�"��%, <br />The Undersigned %'� = ' �- � i�ic _ ' Da�e Approved ' _ <br />Hereby applies for permission to l ^ /' � r-' _� %T `/ - %' :') ;. f-' . —r '' � <br />i <br />At the following location � ��= �- —' f'%%��� �� �! -r%% <br />SKETCH <br />IWork to be <br />�' BEy�RLY <br />LA1!?= <br />The undersigned owncr hereby agrces to hold and save harmless fhe Ciry of <br />Everetl from any and all daims for damag^s Ihat may arise bemuse of fhc <br />installalion and maintennnce uf the improvement hereto opplied for and <br />furlher agree, ro remrne same upon notice from the City and to replace all <br />public properly damaged Ihcreby. <br />Inspedor's Signalu;e <br />.�`Z7�- _ c �/�'c,��7 i���r�- <br />Dafe <br />Remarks <br />c.0 ��,,;��.�����,,: a:����_ �_>:,���U;,o:� <br />24 �1G'�fS bd�UfL' <br />c���n:,truction is started. <br />�,:.,,,. <br />.�a: <br />Variance Required <br />�es _. _ _.... _... . _.. .... <br />No.__...___........_._. <br />� �i .� - `� % � � <br />Telephone Number <br />_ i: <br /><'�`-�f ��, / 9 '7/ <br />— —� <br />Dale <br />.�al/� % � �- <br />Fee <br />DEPT. APPRO.VALS <br />Engine�r�'/. �/1_�f��/�/ 7�! <br />�; Waler—���7t...�6L—,`�y' 7� <br />� Streel _ —" — <br />Communicalions _ -�'•..",_ <br />Traffic �'��'==' ' �� - _ �„ <br />Planning � %�� ��'�;. , <br />�" IVOTE <br />CHE,�,K WITH WATER \ � -" <br />��P7. FOR WATER LINE ` <br />`OCATIONS BEPORE �XCAVATIOM <br />�_ , <br />r�RovieE Fo�t— � <br />PROPER DRAINAGE <br />- -� �_. m._.,I <br />