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�pp��oved By <br />' ,, <br />__�L�.G�_ 3 ��% 7� <br />� , � ; Dale Approved <br />The Undersigned �' ' ' '_. <br />Hereby applies for permission to �� ' �' ' ' 'y� % �' ' <br />i�� N/) .,� /, �.-, r i ll�L r'.�J ; <br />At the following location� % �� � /��� �`� �- � ' � '� � � <br />SKETCH <br />IWork to be <br />' ' ,/3 <br />33 <br />�- <br />� �, � ��%� %�, <br />/t �'�i/, <br />The undersigned owner hereby agrees to hold and save hormless 1he City of <br />Everett from any and all claims for damages that may arise because of the <br />installalion and maintenancc of ihe improvemenl herclo applied for and <br />lurther agrees to remove same upon notice from the Gity and fo replace all <br />pu6lic property doniaged thereby. <br />Inspecfor i $ignalwe <br />SiT:t G�i,��c.,cE�� ��2 / <br />Dale <br />� F'ROVIDE FOR <br />II'ROPER DRAINAGE <br />)'�� � � <br />Qc��.*)RL1 <br />1\'�': ' <br />,.. , <br />.... <br />/NS t� �L G,C'•F ti_^'L DR�!/SuIH y� .�•, <br />.FjNO M. /« (j(/�'�-' �;JT <br />�_ —_ . <br />./ �pr-' 1 <br />�JRK l�'���! <br />���t'�i) <br />,� �� '' "'� <br />c A ��k �P1i� ��� <br />D[PT. FnR VfA t�� <br />L��CATI4NS BEFORE EXC�d,VA��(�J <br />Variance Required <br />Ycs.__.__.._...___.... <br />No ............... _........... <br />�c''��� <br />C.. pr GG�(.�v�i-�._ <br />Signalure of Applicanl <br />Ir"L•',�.�3 /"'G��G�P"JH4't /�(/(_ <br />Address <br />as�' %T�l�,n <br />ielephone Number <br />5 � / �/ <br />oar� <br />5 S. ���1� a.���`'�_ <br />Fee <br />DEPT. APPROVALS <br />� _ `.//'i!� `�'�//7/ <br />Engincch� " -�� �-` � <br />Waler : � �.Cc.-n� .�- V ._ / <br />SlreeL /, ' : ; ` ., � ' ' � <br />Communicalions7G <br />Tmffit '' �' <br />Planning r�j �j � <br />Call Engineerin{; Dept. 25- '.' : <br />24 Hours befrre <br />construclinn is slartetl. <br />