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The U�dersigned_ - <br />Hereby applies for permission to <br />At the following <br />° `:ETCH <br />(Work to be donel <br />� <br />� <br />Q <br />74tie: <br />Datc Appruved <br />'---�f - � , , <br />/_ �I.�' %'il/ D�'/ :':=.._, <br />-�-.` � � <br />/ , �15P. f�l��rG� <br />The undersigned ownen c�reby agrees to hold and sove harmless the City o( <br />Everett lrom an�� and all daims for damages that may a�ise because o( the <br />inslallalion and maintenan<c of Ihe impruvemenf herelo opplied for and <br />4uither agrees lo remove same upan nolice from the City and to replacc all <br />public property damaged thereby. <br />, �� � �� ���/���� <br />�� ;�.� <br />,� <br />L �i' j <br />�, ���� Z� � <br />,_.�� �.� <br />_`i , <br />'�.��'�� -�'--Z 7 �"%, ���__�,. iL.c�:-- <br />Insped�•is S�na� '� `—` -- <br />� ��/�! % <br />Dblc <br />Voriance Required <br />Yes . . .. . ..... <br />NU. . . _. . _. <br />/ �� <br />/ , �'�.. , ;,,_'f' ., ,- ,�F l �'� ' %:l <br />$iy+natu�e of Applimnl <br />Address <br />7�lepho�e Number <br />3 <br />Dol,+ <br />Fee <br />DEPT. APPROVALS <br />Enginaers <br />� . <br />Water /.'/' /o.�,��n,_, <br />Strcet � � <br />Communimtior.s �/! . '�. il Y�'rF.Yl.Li��C—,� <br />Traf(ic <br />Plonning — <br />