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N <br />-- �—-— --�-- <br />/n_Y9C-- ----- --.__ . � <br />__'— ��\�.�; _. <br />�-{ O L- f3 R 0 0 t� <br />The undersigned owncn c�reby agrecs lo hold and save harmless the City of <br />Everett from any and all claims (or damages t!ial may arise because of Ihe <br />inslallation and mainlenance of ihe improvemenl hereto applied for and <br />further agrees to remove same upon nolice irom the Ciry and to reploce all <br />public property damoged ihereby. <br />Inspedor's Signalure <br />�iT6 �NE�'.cFi> �V/7.�7/ _ <br />Dafe <br />Call Fngireori��; U�pL �: ,�c�:iUJ <br />24 Hcurs before <br />construction is slarted. <br />'�\ <br />A �J � <br />�;y• i <br />._i S : <br />� <br />Y�� -�' �feeN <br />� _. <br />!�• <br />pRp1 DE FOR <br />� PROI':'I; DRAINAGE <br />vo��a�« <br />Yes. .. _ ..... .... ......... <br />No.___..._ _ ._........ <br />�, <br />_ . �.� <br />Signalurc o( Applicanl <br />- ',� ' � <br />ada,e,: <br />"� y a - -r / : <br />� <br />7elephone Number <br />Dafe <br />§ /�' '•�-�'tu�-=� <br />2 7 12_ <br />Fee <br />DEP7. APPROVALS <br />Engineer ��"'��?�/D�/7/ <br />Waler ' ,••.• i lG - J - <br />$treet — <br />Communicati0ns 1_r ��'�"�' <br />TraFfic `'�'' ' ` <br />Planning ��+ <br />• r<aTe _ <br />.,;,;,� �..��.:; <br />Gi;F,..:,:.'.i�� ,:. :,2 LI!';: <br />1.0�i�f101'S� GE'r�;iiE 'c.XCF�?•i�ON <br />