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CITY ENGIN�ERS � <br /> EVERETT, WASH. roved ey <br /> _� /// � � ;� � nc�o�zr 'L3 , 141�4 <br /> The Undersigned v ����—✓-� L� f'' , Date Approved <br /> / <br /> Hereby applies for permission to � �S� l�:2 ! ;%��= <br /> _, 1 , i — <br /> At ihe following bcation �- � `` `�'�—� �'' _-' <br /> SKETCH <br /> IWork to bc donel <br /> `;: <br /> �.r <br /> The undersigned owner hereby agrces lo hold and save harmless the Cify of Variance Required <br /> Everetf from any and all claims for damages that may arise becavse of Ihe <br /> inslallation and mainrenancc of the improvement hereto applicd for and Yes. ......_................. <br /> further agrees lo remove same upon nolice from thc Ciry and to replace all No_.. . _. . _......_. <br /> public property damaged thereby. <br /> Signature o/ Applicanf <br /> Address <br /> � Telephone Number <br /> � l� �' Dale <br /> /�A--r-r+.> �-s-�-<Lfc-4� <br /> Inspec�5ignalure $ <br /> �c �7�/�9 Fee <br /> Dal eT <br /> DEPi. APPROVALS <br /> Remarks <br /> Engincei-� � <br /> Water �- '� <br /> -- Streel <br /> Cammunicolions ' � ''` � <br /> Traffic <br /> Plonning <br /> � <br /> i Y'f , ( ,. <br /> �...�,� � . . <br />