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EVERETT, WASH. '- ,� ��� By - <br /> _.�/ ,� � -L. �:'�57.�� .01� 1 '- V...'�i, <br /> The Undersigned ^' ' �' '� r � _ � .��,'i' " '�-%' � Dare Approved <br /> � . <br /> � i. <br /> Hereby applies for permission to ��' ��^=-� ✓" � <br /> v <br /> „ <br /> -:. --� _ �, / • /' . <br /> At the following location � - = ��_�;�L�� _ <br /> _. ----._„� <br /> SKETCH <br /> fWork to be donel � <br /> —__— <br /> I <br /> �/�! < /�/G ,�' ;%,=/ ,� �'E <br /> i . ,f , , <br /> �-`- - --- ----- ----_- ---- __ - <br /> a !�L/r i✓"i c,e� <br /> 1 � <br /> � <br /> � Se/G EN ��'GL-'1 � <br /> �� { <br /> f/AS�cL� S C .�P � <br /> n , <br /> � <br /> I � <br /> m <br /> The ur,�ersigned owner hereby agrees lo hold and save harmless the Ci�y of Voriance Required <br /> Everett from any and all claims for damages thal may orise because of the Yes . <br /> installation and maintenuncc ol the improvemenl hereto applied for ond No <br /> foriher agrees Ic remove same upon nolice from fhe City and ro replace all � �� <br /> public property Jumaged thereby. �` <br /> ���-,���/. ��j��l,o . ; ,-. � <br /> �,:_ <<,�/� /:'iicz,:L"�r r� <br /> �C�,/ " Signa`ture o Applicanf <br /> � ' <br /> ������ � I M� <br /> Addresv <br /> .�.�o�� .' ���s !�o�e,�/ Lf/a_, " - � ' � � � �� ` <br /> ielephone Number <br /> OO�vc! Ic3e'FUr� /yS�ecfio�r /?�`'�- y <br /> ' �'�,•s .�1cCdP. Dafe <br /> -�._ti.. �� J � ,� �c.Qt� <br /> �Inspecfor' Signafure �. _ <br /> /Z ��'�9 Fee <br /> J� <br /> Dale� �' <br /> DEPT. APPROVALS <br /> ,lii..�c- � . <br /> Remarks "��'�' � Engineers •�'�� � - - <br /> Waler � _ <br /> _ S�rcel. JJ . 2.t.ti _li���v• <br /> Commumcations�_y,...�� <br /> Traffic ����� <br /> _ _ Planning ^ <br /> / , r <br /> � 1 <br /> i r , <br />