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EVERETT. WASH. <br />Approved By <br />The Undersigned C ON 0,90 L a u r n% Date Approved <br />r <br />Hereby applies for permission to ( e.-V 7. 1/< <br />At the following location Z 3 11 — L k ! A f-i O M A AV 6. <br />SKETCH <br />(Work to be done) <br />The undersigned owner hereby agrees to hold and save harmless the City of <br />Everett from any and all claims for damages tho, may arise because of tl,e <br />installation and maintenance of the improvement hereto applied for and <br />further agrees to remove some upon notice from the City and to replace all <br />public property damaged thereby. <br />r <br />Inspector's Signatura <br />S-1:2' CNCCLI�I `7r� 7Z <br />Date <br />Remarks <br />N0TZ <br />Cf{�: %VI T f i V:',Y.TER <br />.C,rtV,AtLi tlr, <br />38?6i <br />EjUf,7LvG <br />vcAQl <br />Variance Required <br />Yes _ <br />No <br />Signature of Applicant <br />? )t1 D /- <br />Address <br />Telephone Number <br />�- -7z <br />Date <br />Fee <br />DEPT. APPROV/fL5 <br />Engineers E'!r-,5/.?�(72L. <br />Water�— <br />Street <br />Communicalions� <br />Traffic' <br />Planning <br />Cell Engineering NO. 25.4 E803 <br />24 Routs kerolc <br />construction is started <br />