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� <br />t�.. \ �-1 � 7 <br />�� � y,���t��fs��:> � <br />� � . . . _ <br />� <br />-4�PE� <br />µ� r��, it o". �_��fi'n,./f: f C�vr.n ; a�,-`i:. <br />--�r�- � �// � ' ._L:_...-.-_' J'.�-r- ' R:_. <br />. ��. �`�`�-�� -_. . <br />L,�+ %5-T�,1:��, ��� L.�^l�; �Y�`.. : r.'Y,-� .�z3, <br />. <br />The undersigned owner hereby agrees io hold and save harmless thc Ci1y of <br />Everett from any and all claims for damares thaf may arise becav,e of the <br />insfallotion and maintenancc of thc improvemenl hereto applied for and <br />further agrees to remove same upon nolice from the City and to replace ell <br />public property damoged thcreby. <br />` ..,.�� } /7 <br />!_y Y'ri <—�' C `��S'� <br />Inspecfor's gnafure <br />�/� � �� y <br />D� � <br />�� <br />Remark: <br />Variance Required <br />Yes.._ _....___.__..... <br />No__. _._._._..._._.... <br />$ignalure ol Applicant <br />ielephone Number <br />Dafe <br />� <br />Fee <br />DEPT. APPROVALS <br />�°,:=�� <br />