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' �"��c" . <br /> EVERETT, WASH. Approved By <br /> � / /���� ,2�, /�1�' <br /> The Undersigned %��`-'��� L,��'��''�✓ _ Daie Approved <br /> /� � <br /> Hereby applies for permission ta / '4`��'�'� c��'�? �y�'' `��'� �'''`{� <br /> Atihe following location �" �r� �-P�� ���"��t {� ' <br /> SK[TCH / <br /> (Work to done) � <br /> � : `� `<'_ '� <br /> , <br /> � <br /> Q �? <br /> i <br /> � � <br /> _ t� � <br /> PE��GE PG�i Cc — �,I <br /> �� ;� ; � ,� <br /> �' ` . <br /> � �C <br /> � <br /> � <br /> I <br /> � h � � <br /> a `� <br /> QASP. c'AMG G'�;✓� �l <br /> p� � <br /> \ 'L �� V� <br /> 2� 2s �:,, Z. '- <br /> � , ____�-_-- <br /> J <br /> The undersigned owner hereby ogrecs to hold and save harmlezs the City of Voriance Required <br /> Evereft from any and all claims for damages ihal may arise because of the <br /> Yet__ .... ...__.......... <br /> installotion and maintenance of the improvement hereto applied for and No . ._....... <br /> further agrees to remove same upon nolice (rom the Cily and to replace all �-� �� ��-��� <br /> public property domoged lhereby. <br /> ' L'l�i� . ..:w.'.: . --y_.; , rilN f . <br /> f hi ti� .i C i.' . s: r�� ;%_�-} / !� ��.ti.�._ � <br /> �4'-� '�i �lr ka.-) �\i...�>�J <br /> . <br /> ' Signafure oI Applicant � <br /> �M 1 � I <br /> �� <br /> E �_/ yk3� � �'�' . <br /> __ �� Address <br /> ' !'`-_��- - -- ; <br /> � •� 3•SS - /7/3 <br /> .� Tefephone Number <br /> �. ' . . <br /> � <br /> �'. " / `���'c��/~f!f <br /> Dafe <br /> .1V.iwAY .�.S6cT10N �i' a� . <br /> Inspeclor's Signafure ' S � -�' '-/ - <br /> ��ViO SCRts � • <br /> C � - . ^Q S� � Fee <br /> Dafe % b� �r <br /> � /.-� � � ���LI P i DEPT. APPROVALS <br /> �-� ,I i � � ( .,; �;��� '� t �� <br /> i -%�+� t•.�-A. . _-r { • ' � �� ' ��`S"�!� �7O <br /> Remarks ;% €nc�incers / - <br /> f ' �a�er <br /> reel . // - : ,. ::�':.. �.'_ <br /> Communicalions 7� ����"""^^f",�-=—�._ <br /> Tmffic � <br /> Planning F'�l' <br /> .,,, + L.1 . �I <br />