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SKEICFI <br />lWork to be donel <br />10� <br />r <br />�,[� � /./ U � �' ; <br />�- c <br />U <br />5 <br />�5P ��/vE <br />The undenigned ownen c�reby agrees lo hold and save harmless Ihe City of <br />Everett from any and all claims for damages thal may arise because o( the <br />installation ond mainlenance of the improvemenf herelo applied for and <br />further agrees fo remove same upon notice from the City und to replace all <br />public property damaged therehy. <br />C'lt-�-t..l'�t' . <br />�7 ✓' <br />� i / ,tLe <br />���r�,v ,;�,,��� �ti�4 �,��<,d� � �- <br />'�:� s-/.`� „ , c�• � ���,. <br />., <br />�l � �/�i� ,. <br />.�/J L.I�GYz41-.�'-N. <br />Inspeclor's ' alure „ <br />Dafe <br />� <br />r <br />4 w <br />i�4 <br />I" ` 4D� <br />Variance Required <br />Yes..... _. _.... _............ <br />No... _ _ _ _. ___._....... <br />� �, i " <br />�T � :;� I: i + <br />/�> ;i2 i�. ,;� <br />Signalure of Appliwnl � _ <br />Telephone Number <br />Dafe <br />Fee <br />DEPi. APPROVALS <br />Engineers �'' `� � i'*—^ <br />Water <br />� . . - <br />Streel <br />Communicalions: .� � � �-• � � .��� �" - <br />Traffic <br />Planning <br />