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The undersigned owner hereby agrees to hold and save harmless the City of <br />Everett from any and all claims fo, damages that may c-ise because of the <br />installatio.i and maintenance of Ife improvement hereto epplivd for and <br />further agrees to remove some upon notice from the City end to .cplace all <br />public property damaged theraby. <br />Inspector's Wature <br />Date <br />Remarks <br />I <br />C" <br />Variance Required <br />Yes .............. <br />No_._...._.. <br />Signature of Applicant <br />Address <br />Telephone Number <br />Date <br />Fee <br />DEPT. APPROVALS <br />Engineers U " �--� <br />Water <br />Street __ C <br />Communications:{y% <br />Traffic <br />Planning <br />