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CITY ENGINEERS <br />EVERETT, WASH. <br />F.�, <br />The Undersigned '—'`" '' i ,= " <br />Approved By <br />Dale Approved <br />� <br />Hereby applies for permission io �-- � �� � -% �-5 ����'%� ` /''� ` - �''' � J�l'� <br />At fhe following location ���� �� '' ' ���� �' <br />SKETCH <br />iWork to be done) <br />J� <br />A� j Ni <br />i-�i�/� /�t./�-� sT <br />7 6 5 ' 4. <br />� ; r : �,,� . =:� :: . <br />�I �/� <br />-r ,g., �, <br />�------ '�z —N <br />The undersigned owncr hereby agrees to hold and save harmless the Gity of �( /" ' �' <br />Everetf irom any and all claims (or damages that moy arise 6ecause of the / {�6fY' :y� A'kj � <br />insfallation and maintenance of the improvement hereto applied for and 1� j'1 /j�� <br />furihcr agmes lo remove same upen notice irom tlie City and lo replace all `I� _. // ✓ c�� l� <br />public property damaged Ihereby. (�" Fi / <br />�� JI'�'��H�� <br />�� , <br />(/�i��//�- ���2 �� J <br />� ,/'ti/ <br />C���� <br />.. :.)i��.l <br />Inspeclor': $ignafure <br />S�r� �i.�i_sGC.£v �� �70 <br />Date <br />Remarks <br />Call Engineering DQpt. 259 88N <br />�, 24 Hours before <br />coastructlon is staried. <br />�� m ` / <br />do �% <br />�� \Pv i <br />G `� I <br />� ,'' <br />_ C'r �'�� <br />r � <br />v�,� ;' � <br />�' <br />�� <br />i <br />'' <br />Water <br />Sf rect . <br />Planning <br />Variance Required <br />No................... ....... <br />l <br />,.. <br />�-�1' � •.�7 t�, ,� �' � 3 <br />'--� � <br />)�� ��:� /. � I <br />,� , � ;f-; _ _, .�c,x��= <br />� �$ignofure of Applic0nf <br />� . �, . � �.,. <br />Address <br />.-3 . - : � % , -- . <br />._7.J_'� �:-?"�-('- <br />Telephone Number <br />U���. <br />� Dafe <br />g ll/n f=FF <br />Fee <br />DEPT. APPROVALS <br />.�... . . /. ? <br />. ...� . .�. � __ <br />��y i�<f .•/•t.� <br />/,!, i i n , n .. <br />/ .�:...0 <br />,. �• <br />