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At the following location <br />SKETCH <br />(Work to be done) <br />I <br />I <br />t <br />I <br />, <br />I <br />, <br />2413 <br />I <br />I <br />I <br />t <br />41 <br />I <br />r <br />The undersigned owner hereby agrees to hold and save harmless the City of <br />Everett from any and oil claims for damages that may arise because of the <br />installation and maintenance of the improvement hereto applied for and <br />further agrees to remove some upon notice from the City and to replace all <br />public property damaged thereby. <br />SFCi: ON <br />1V s <br />r <br />I <br />Inspector's Signature _ <br />Date <br />PROVIDE FOR <br />PROPER DRAINAGE <br />Sac <br />i <br />RECEIVED <br />OCT 14 197O <br />Water Superintendent's Offiq <br />Remarks <br />Sr c - Y_ ,q/Y 7-S- 1 �i rF 1��; �1J �),��-70 <br />Call Engineering Dept. 259-8803 <br />24 Hours before <br />constru ; started. <br />355r4 <br />•�Ze <br />Water <br />Street. <br />Traffic _ <br />Planning <br />Variance Required <br />Yes X <br />No .. _. <br />Signature of Applicant <br />�ve'-rPL�17Addres: /Y/�Q,rN <br />Otis 3 -2 — --;I-- <br />Telephone Number <br />e7 7,1 <br />Date/�/ <br />E �5—� 43-t }�` 't io/i9�7a <br />DEPT. <br />Fee <br />