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The Undersigned Po u� 71 � o t'� �' Y' � F�l � n I l �' o n�t � �, Daie Approved <br />Hereby opplies for permission <br />!c' <br />At the following locotion .�t l� M � k, /f eo �l v� <br />SKETCH <br />IWork to be donPl <br />� <br />—_J. _— <br />Mukilteo <br />---- - ____,. <br />� <br />-------- ---,--- <br />���OG� J�VRt1NNT <br />F3lvd'� <br />J,z"c�!-uE2T rO �'� <br />�'Ns7'.�«.c.E D, <br />The undersigned owner hereby agrecs to hold and save harmless �he City of <br />Everetl from any and all claims for damages thal may arise because of 'he <br />installotion and moinfenance oi thc improvement herelo noplicd for and <br />further agrees to remove same upon notice from Ihe City and to replace all <br />public properly damaged Ihereby. <br />fcT.�rhy: :� �_5tC <br />(1V�-_ 'SC AC E � <br />�� _ �„ x�� <br />� _��l�i P --� <br />Inspedor's Signafure <br />�:.= �'y2 c.N�"i� 7/ /7� <br />Dale <br />L'all Engineering Dept. 255�8803 <br />24 Hours before <br />consiruclion is starfed. <br />3'71;-i <br />PROVIDE FOR <br />PROPER DRAINAG[ <br />Variancc Required <br />Ycs.__..__....__....... <br />No. .__.._. .. _.__.._. <br />„ <br />- sn <br />[-�1 G7r•L G �2: .� ;c �. �r,, <br />, � Signalure al Applicant <br />/__-=._ �,t.=...�a� �=—..:._/.`_::.__. <br />.�ZB- '�/ sr �G� /t/�. Et�X'�etir'T7. <br />X <br />Address <br />3' S� 5 t�� <br />ielephone Number <br />'� 30 � � 7/ <br />4/f/,.l�d�.� i <br />Dafe <br />� .r. <br />� M-�„�I �/� /7� <br />�.� � ����. � <br />Fce <br />DEPT. APPROVALS <br />��/ <br />Engineers • `�"� � � �/ <br />Waler �i.�.f.�,. i`E� ii <br />, i <br />Street � �'�' <br />Communiwlions �" �� '� 1- <br />_ ... Ci�L ., . •y/: /o� <br />Planning <br />' fVaTE <br />CHECK WITH WATER <br />DEPT. FOR WATER IINE <br />LOCATIONS BEFORF EXCAVATION <br />