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;h: U.�dwsigi��a----- <br />Dole Aoprovcu <br />� ' _ �� i i �� " _ - - �J�� � �''� (�`J IJl_ . r�,.- �,._ , . ;. <br />liereb apnlies for permission fo �- <br />A!;i:e follcwing bmtion G�`� "� • �-' �. - ' -� • � — '�— <br />The unders�gned owner nereby agrees lo hold and zovc harmless the Cify of Voriancc Required <br />Everett from any and all doims for domages Ihal moy arisc becouse of Ihe Yes . .._. _.._. <br />instollation and mainlenance of ihe improvement hereto applicd for and No. <br />further ugrees lo remove same :pan nolice irom the City and b reploce oll ��� -���- <br />public property domaged thereby. <br />ORIVEWAY SECTION <br />NO SCA�,E <br />f--- �-s -� <br />+I" LIP <br />� <br />30" _ 30" <br />�'1il/�LL�P �'/ — .�i� /i:L�7.J /J,'e?Z2 <br />Inspector's Signafure <br />S,iP �'�P�,4,✓ 2�..�G��%S' <br />Dale <br />Remc; ics <br />g�'! � ` i��?TE <br />:t�'i frit:,lq:�:rii.' .: � �59� CHECK WI"iH WAT[k <br />,,,; i�, ,;;_, , UEPT. FOR WATER LINE <br />c:rsiru�?i���?, ���d. LOCAT:^NS EiCFORE EXCAVATION <br />�"� � - <br />�,.�. , _ <br />- ^ = � Signalure of ApplicaN <br />,, , <br />,� <br />Adaress' <br />ielephone Number <br />`�i" � � � r <br />Date <br />�I ���SO� _` <br />� � � ! Fec <br />�i�.��.__ tJ -�• �. -l�t -_ <br />_'z�- ;;,:. <br />DEPT. APPROVALS <br />Enginecrs �. N��ril �� ?. l. ' � -J <br />Water , ` l� , , j , . :=� <br />� � � . <br />_ Strcet �..�� s ._ i: �� _ l-..; �, r �� � <br />� =?-� + - <br />Communicatiq , � � � � ' <br />Tm((ic �__�_,� �—_�..._�.'7 ,i2''v .% . J <br />— Plannin`g:: � �) . ( ..�l:f..-�.,t�t.rr� 2.�. %"�¢• <br />... . . . . - -.-.. _.. . . . . _. <br />� .,U�,.,: �i i-�. ' � <br />{'F�l�!��� Uf<hi�ivlll.� <br />� <br />� ..<,� .�.. <br />