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■ <br />EVERETf, WASH. <br />Approved By <br />The Undersigned � RS � i-i �/ l._. L �� �C�D E' 1�: Dare Appro��d <br />I I <br />Hereby applies for permission to ��1=-�T � L,�� _ IAi R'TF2 L I IJc J i� i G�. i�' P 6'-.'� �' <br />J <br />A� ihe f��llowing Inccfion-39 3'� �,� � S'= � l� �-�� . _ <br />�SKETCH <br />iWork to be d nel <br />��" <br />_ � i £�o' � <br />U��r � rt <br />l-iNE To 3� <br />�:I �LC1T <br />� <br />� <br />d I <br />�' , I <br />� ' <br />n' <br />----- — <br />I S --- <br />n�p �.�N To <br />{��NOA I�� <br />�� <br />�GF,LL <br />� �xi5-f . WA-rc:IL �INc <br />� ��===1-- <br />13 <br />---- -- 393�' <br />14 <br />�----- _ <br />,s <br />, � � i / �RvPo�E.�] 1'� ��A'�'�\Z. Y-IfJc <br />� —� ll `� _� 1' 9'� �� <br />; — � -� ' <br />! �� r — .- ..�1/ � ' . --- — -- <br />;y a. _ '- �.c.. -: — - <br />L / <br />�X; s �..,, ' � iiFc./ Ajotr,ut .Cf%�� <br />� �.- � . ,� ;>> � .: �,,: ; ,�;Q `, <br />�%i4G� 1�1 ' � �•;J <br />6uqrEfl�-- —� I ,� <br />' � ' 14: <br />� f1 � <br />Thc undcrzigned ownen c�reby agrces lo hald and save harmless the Cily of � . �J l <br />Everett Irom any and all claims for damoges Ihot may arise bemusc of Ihe ii•i' <br />insfallalion and maimenance ol the improvemenl hcrclo applied for and '�� � <br />further ac�rees lo remove same upon notice from Ihe Cily and to rcplace all ` ��� <br />public property damaged thereby. J ` <br />Intpeclor's Signature <br />: ��� ��r/;�i=i� `f :�-J`f <br />Dale <br />,.� � i''=�" • <br />�! Cnp��r�eFn��,: `�. .. � N"L`YE� <br />^,1 �;.,i:; , i C;qiP CHECK WITH WATER <br />mnstf���,��i��r ;tafled. D�PT. FOR WATER LI�lC <br />' rnr[. '.':'. '.',".'. <br />� ,...�r!�'r'4 �i-. � � . <br />Variance Required <br />Ycs__.._._._... ........ <br />No. . . _. .... ... <br />� <br />, .., <br />;; , <br />,, , <br />SignaWrc of Applimnl ' <br />� , <br />� f � �G <br />. i- „��j,� �j� �_.%r , . i•":a,� ,. ...; <br />Ad'dress � • <br />T L' I i-f .. :./+..' i��a <br />� / � <br />Telephone Number <br />'� / %� - l <br />�����L� �7f� <br />Dale <br />� <br />� � �` r-��., <br />� r� ��-/ �=C�i Fee <br />� � :'�- �� <br />DEPT. APPROVALS <br />Engineery/}—y �7� -• �- <br />WO�Cf \/ �—i .. i (Cl: C . <br />/ t-'• <br />SIfCC� � �/,��� � <br />Communicalions- � <br />TraFfic � � � <br />Planning � ' <br />.. ..... ......... <br />PROVlDf_ f Uii <br />PROPER CIRAINAGL <br />,.<�..y.. <br />� <br />