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CffY ENGINEERS <br />EVERETT, W,45H. <br />,� / : <br />The Undersigneci� � ' � f / `"'��-' <br />Hereby applies for permission to fi!�-�� / `+'./ ,� `� ' '�-- � `! <br />At the following <br />SKETCH <br />IWork to be donel <br />G` 2 c"o <br />`...........�...,, <br />.� ,.�.....��.,..,-. e,w P�.... . <br />The undersigned owner hereby agrecs to hold and save harmless the City o( <br />Everefl from ony and all claims for damages thal may arise because of the <br />installation and mointenante of the improvement hereto applied for and <br />furlher agrees to remove same upon nolice fiom tlie Cily and to replace all <br />public property damaged thereby. <br />iLrY7�' �r_k—�'� _ <br />�ns eclor's gnafure <br />/�'� 7- � <br />Dafe <br />�proved By <br />l�ri-pbev" 2� 19b4 <br />Dalc .Approved <br />Variance Required <br />Yes... _ _.. _.. _... _. _..... <br />No_ _ .. .. ................. <br />Signalure o( Applicanf <br />Address <br />ielephone Number <br />Dale <br />Fee <br />DEPi. APPROVALS <br />Engineers ���'•� <br />� <br />Water - <br />Strcet <br />Comn+unicalion5 '�'i" lC.. �-r �1�_� . <br />Planning <br />r � <br />