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EVERETf, WASH. <br />Approved By <br />i- - <br />The Undersigned �" � { I - t '-'1' � ) } : 4�1 • � � .. i i '�- Da�c Appruved - <br />, <br />" `� 2 r'� C� � '-�i G �-i � s--�. � � •, _� ' ; : <br />He�eby applies for permission fo L�%�� � `� � <br />'�� �`�.J� i_ . _.. ���. � l� 1 i �-/ ���^ ' � j-�'T`r� �`' � <br />� 7 _ Q D C. -- � � . r. � _ � . �� l . � �� � <br />� ��� �i��- `- -- _ ' J �.. / / � L- . <br />At the following locotion ��-'_ - <br />to be donel <br />,_.�..T. .-. � � �, � _ . <br />�V�,,. L,�,�)� -. �.L__C� �V`✓� <br />The undrtrsigned owner hereby agrees to hold and save harmlezz Ihc Ci�y of <br />Everett from ony and all daims lor damages ihal may arise becouse of Ihe <br />in:lallalion and maintenance of the improvemen� hcrelo applicd for and <br />}uriher agrees to remove same upon notice from the Cily and fo replace all <br />public property domaged ihereby. <br />Inspecfor i $ignalure <br />`l i i i� L.'�.��/`�i%�..G �� �~- .. C�. _ . %' <br />Dale <br />�:all Cngineering Dept. lS'J �203 <br />24 Nour� before <br />i On`ifqf'I��fl K "�'�f�C(�. <br />` FJOTE <br />CNECK WITH WATER <br />DCPT. FOR INATER LIPJE <br />� r��,n n�,�.,< Rf rORF FXCnVA � �n�� <br />? .. C <br />Voriance Required <br />� <br />Yes ... ...... .__... <br />No._ . ..... . .... . . <br />s '' <br />�NC/F`IC �n/CR'.Es7f. %'tan.tMet��, ,l,ct <br />/f!2•• ' / C �l •:Z �/'i.ir ' P,�' �',Sl <br />Signalure of Ap�i N <br />�Q �� ' ` ���� -- <br />Address <br />of';,�'- 4S�b <br />Telephone Number <br />7 — /9 — <br />Dafe <br />f� <br />� � �, 1 ,� . <br />}i i �.7� Fee <br />V(�C i'� l� C `� yL. <br />�- � _iq._ �� <br />�EPT. APPROVALS <br />Enginccrs�, ' <br />Water_�i.�/ ?'�j.!�h- , <br />Srrecf :1�: ° - - -"� <br />�' <br />Comm�.micationr <br />Traffic.��/c'r, <br />Plannin�...r< � � � � /J" ., ., r�_�� <br />�- - - FGi� - --- <br />� , . , <br />i F;:"; �.R DRAINAGE <br />I_ <br />