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Hereby applies for permission to <br />At the following location <br />SKETCH <br />IWork to be donel <br />The undersiyned ownen c�reby ogrees b hold and savc harmless the City of <br />Everett from any �nd all cloims for domages thof may orise because of the <br />insfallation and maintenance of the improvemenf herelo applied for end <br />further ogrees }o rer.�ove same upon notice irom the Ci�y ond to replace all <br />public properfy damaged thereby. <br />it:'!.1 <br />DFiIV.E`:�,=,Y. �_.StCS10N <br />ffilu SCAt�) �r�� .C7RIYEiJAY:_S[[TfON "' <br />4 <br />~ r, d �� SOM <br />� ���� I <br />� ._� I <br />Inspectoi s Signofure <br />J`%T7�" �fi�F i� i) T i.ZT�Z� <br />Dafe <br />Remarks <br />C�II En�inee�; �g Dept. 259 8803 <br />24 Haurs be(ore <br />�mst�uction is sfarteo, <br />�.�.--�--- �..'_" y� <br />„ <br />� ` . .,-_..�= _.� 3�' <br />P/d.. �,+r'_'....__ WR <br />-$ca <br />� ' NbT� ' <br />DEPT�. F61��1�1� ����c <br />ldcarloNs r�F;-;',?i�- �^,?��'�i1Y/hT��h' <br />%4 <br />Varir.nce Required <br />Yes.._. __... . <br />Jo <br />. � Signafure o( Applicant <br />_ � _/ %`. � , � ; �� . . <br />Addresz <br />Telephone Number <br />Dafe <br />r ,� <br />5 ' <br />J "� �'4 � � , <br />Fee <br />/ ' ✓ <br />Engineers''--` . �" <br />� Waler_�—� -��� i1^'i- � <br />Strcef � <br />Communicalio �� � � n <br />TwHic �, <br />Planning ` - .-. <br />PROVIDE FOR [ <br />PROPER DRAINAGE � <br />_. ,,._ . ..........-...�.._ I <br />