Laserfiche WebLink
EVERETT, WASH. <br />The Undersigned �' �' ' ^ ' �' � = G -� <br />Hereby applies for permission to �- � ��=� ' �� - �� �' '! <br />At the following location � -' � i J , . j' : ^ /'' /7 � `✓`/✓ ;=' � <br />SKETCH <br />IWork to be donel <br />� <br />.- -� <br />� �� <br />! .c:' �r� ' J- <br />' Approved 8y <br />� �t"l.�/�/%/j.F. i� Ff �J �7 %� <br />Dole Approved <br />O � L � �� �;�� , <br />�- f/�... '���..' <br />� <br />i GQNS,TR„�:"T iJ: i•J -h�U <br />/� '� / /" r // <br />TD r`: :-c1er� YJiri rx!'" 1/��n; v <br />I <br />The undersigned owner hereby agrees to hold and save harmless the Cily of <br />EvereH from any and oll dcims for damage: �hat muy arise Secause of Ihe <br />installafion ond main�enancc of the improvement hereto ripplied for and <br />further agrees to remove same upon nolice from Ihe Ciry �.nd lo replace all <br />public properly damaged thereby. <br />:`=:•Ait71'JIENT APF�ROVALS <br />�roEe� <br />�_.__��.�__ <br />�.Ti:H 5� <br />� rT $UPT. - <br />_.�.,�?;iCn��,Yr <br />'"FIG'[NGIWEE <br />��',r��;:,��; :r�ci,d <br />Inspedoi s Signalure <br />,,.�;: F i� C.rr i 9/�g /iU <br />Dale <br />SUPT <br />Voriancc Required <br />Yes ... .. __._......_. <br />No. _..... _..__.._.. <br />��- / . <br />/� / • � / <br />�,�/��i1/l/�/2�..-�/1 �f-�A/ <br />Signalure o/ Applicanl �� <br />� ' �l <br />r�•, . � - . . i <br />.� lJlli�,:,� n - <br />_ ,��R�,��u9dl�L, �i�rr�;�-, <br />�r���_ - <br />Telephore Number <br />9�3�70 <br />�ar� <br />S Ai0 /�=�,r � <br />EngineErs � <br />Water � <br />Strecl�•' '�� -� <br />Commvnications <br />Traffic <br />Plnnninfl _ <br />Fee <br />DEPT. APPRQVAL <br />�ti���9/� �T� <br />/ : <br />� <br />