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EVERETT, WASH. <br />Approved By <br />, r.1JNF /.9''l0 <br />The Undersigned ��/' -' �"���'�� Daie Appro�ed <br />Hereby applies for permission to ��" /'-� � � ='_= � ' " ' .=.1'- ' '':�"' <br />At fhe following location �� ��l �� <br />SKETCH <br />IWork to be donel <br />� :4 /��L'._. [_. <br />3 � rN <br />The undersigned owner hereby agrees lo hold and save harmless Ihe City o� <br />Evcrell from any and all rlaims for damages that may arisc 6ecausc of the <br />installalion and mainlenance of Ihe improvemenl hereto applied for and <br />further oyrees lo remove same upon notice from the City and tn replace all <br />public property damaged thcreby. <br />19 <br />� ,ecPL <br />�� :ocziv�,.��,<,�i _ --. icN__ <br />�8 � --91 <br />; �--, -- - „ <br />j _..�-�� _ --__ � <br />: _.4_ W/' . <br />� P��..� --.=—.--- - _ __ ' <br />� �No:.s.a4�r-.L-- <br />�_ _.._ ��M.+•,-_ ...-_,.,. . �_:. _, :uN <br />, 1 � . �c:s.$) <br />Inspecfor's Signalure ` <br />� <br />�V�E <br />2� � <br />: > : ..: c N/.�."!: ( <br />S T,2E� j <br />J t:ir <br /><� <br />Variancc Required <br />Ycs........ _............ _.... <br />No_.._.._ _....... _....... <br />���i(�' o�c'-�ci't...��....._ <br />Signafure o( Applicant <br />Z J' �,� � -y.-f �'� �'-�-� . <br />.4ddress <br />��., �- 7ta �i=�1 <br />ielephone Number � <br />___.__ /o / �^' 7 c� <br />Dale <br />— $ 1� - 2t �, - �{�� _ cJ <br />� a � <br />,..�LLt �,1���%� ��b �%G� � �� - -`- --'_ ' 90 ' Fee <br />Dale � . - ..._�- .' = �_ ��.::: - -- <br />� t�._.... �_^-:�--23" � <br />� /;-'I�i� � 1�..,�./%. <br />f <br />� <br />q DEPi. APPROVALS <br />^. --- -- F.ng hecrf -7�. `��-7 Y ��E /%O <br />Watcr ` "� ' �J • ' � `2_— <br />_ $Irecl <br />Communicalions �r�/�.,. _ .�>.-: <br />Traffic � <br />_ Planning <br />