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CITY ENGINEERS � , ' ,`-"'w <br /> EVERETT, WASH. roved ey <br /> � n.��ober 23, l`3��C_ <br /> j�/ . . ,�/:� .."� r. . "_ �' . Dale Approved <br /> The Undersigned, � -= �' ' '" <br /> Hereby applies for permission to "� /���--�'� '�r"��F <br /> At ihe following lumtion �� ' ��-'� �� ' <br /> SKETCH <br /> IWork to be donel <br /> r� <br /> f�j <br /> �r <br /> Thc undersigned owner hereby agrees lo hold and savc harmless Ihe Ci!y of Variance Required <br /> Everell (rom any and all claims !or damages Iha1 moy arise because of the Yes.... .__.__.._._..... <br /> installalian and maintenance of the improvemenl hereto applicd for and No_.. _._....._.......... <br /> further agrees to remove same upon notice (rom the City ond lo replace all <br /> public property damaged Ihereby. <br /> Signafure of Applicanf <br /> Addrezs <br /> ielephone Number <br /> � / Dale <br /> 1 ��- `c-1 1 ��i--a-a..f_�C-�-f <br /> Insoeclor's $' nafure — S <br /> Fee <br /> �o%�.�> 9 <br /> oa�6 ' <br /> DEPT. APPROVALS <br /> Remorkt Enginecrs � " �' /�� <br /> WO�Cf� G <br /> S�fCC� � <br /> Commonicalions ' ' '`';�'� � <br /> Traffic <br /> _ Planning -- <br /> � ' <br /> , ..� <br /> /�^ \ , <br /> ( .$Y� <br /> � <br />