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EVERETT, WASfi. <br />The Undersigneci <br />�lNsoti) <br />Hereby applies for permission fo_ � n �J S T Q / �� ,p�L(/ <br />. _._._Aaa�o��d ey <br />L �i/�/r_ /�� . 'i�/� <br />Date Approved <br />At the following location � z o l- o k_ � x� N n r�1 �- ,� V�' _ <br />SKETCH <br />fWork to be donel <br />\ <br />\ 10 <br />QK L A I-� O Nl A <br />The under:igned owner hereby agreez fo hold and savc harmless ihe Gily of <br />Everett from any and all claims for damages that moy arise beca�se of th� <br />instollation and maintenance of Ihe impro��emenl hereto applied for and <br />further ogrees lo remove same upon notice (rom the Cily ond to replace all <br />public pruperty damaged thereby. <br />,t . , r <br />;s : , <br />��/��7it,i/Z l�v"-�t 1 � � � S {''n . <br />Inspecfor's Si nafure — �1��'LI✓ <br />i <br />��i%�/[.. L_ithL/.:�`��J �',�' ,'-l�7 <br />Dale <br />� . �� <br />r r.�.;,-:.R UnP,!Ivi�l:L' <br />Vario�ce Required <br />Ycs_........._ _.. ._. ..... <br />No..... _.__.__...... <br />% �. <br />i�' /. ',- - <br />Sign e cl Aoplicanf <br />1�n9�>�. ��•�' <br />t'.ddress <br />�>��— i�>�3 _ <br />Tel hone N mber <br />S � J �� <br />afe <br />$ ,� ��c :� �i<..,� �'�7Z <br />_ ,� _'7' i,s <br />FeP <br />DEPT. APPRO\'ALS <br />/�%"� / . <br />L�t_.C✓/�//-�;L ���� �i,:-- <br />Engineers � � — <br />Water 1.1., � — C. _ z <br />Street -- <br />Communications_ � � � z � - 72-- <br />TroH�c�-�, cl4f+- <br />Plcnning _LS: n -� • !'_-- '� s - � �. <br />� �� <br />� 4' _ _ :,�,. <br />� � . ... : �! i�'i 'ld;�TER � � <br />C; ="i � Fi�R WATER LIt�F �\ <br />LO.,ATIONS BEf'ORC EXCAV'ATION'-� <br />