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i � I � . .. . -��.�' <br /> tVERETT, WASH. �. � � V Approved ey <br /> 1 � y� <br /> V _/fr "r Mf� :.E',_T :�1L <br /> i r:. , -�., /� �� Dole Approved / <br /> The Undersianed �' ' ' — -- <br /> Hereby applies for permission to �-' �-���=�� • fi_ 'J� u� <br /> At the following location__�_._��� - ��v r_v_ V i r 6tl /3 L v G _ <br /> SKETCH -- -- ----- ------- <br /> IWork to be done) <br /> _R���ove ARf ia a� <br /> � G;:srin�G O�PrvGwAY <br /> R4VERV � EW BLVp . <br /> ,.:, a_r; , <br /> — --� z,� -�- ----- - -- <br /> ���-4D� <br /> I <br /> 1 Zg2° N <br /> I <br /> � � 60 _ <br /> m <br /> � <br /> � <br /> 9p ;OC� 101 <br /> The unden�gned c•,vner hereby ogrees lo hold and save harmless �he Ciry of Variance I.equired <br /> Evereff from any and ail claims for damages that may anse because of the . .._.. ._ . <br /> Yes... . ._..... <br /> inslollation and maintenance of the improvement I��creto applied for and No.._ . . _...._. <br /> (urlher ag��ees fo remove same upon no�ice from the City and to replace all <br /> public property damoged thereby. <br /> ( � ; r. ����'�. <br /> :\ �%�� 1�ri_.:�I �� R:;� . <br /> r Siynalure ol Appiicanf <br /> / <br /> C S3 3.3 F'f'/�KS/O� ��E' <br /> � d�ress <br /> \ N/AR YSY/L� <br /> � (oSy- Co(o5 �+ <br /> / Tele�honc Number <br /> � TJF� ; 159� <br /> � <br /> Dale <br /> InspeUor's Signolure $ �d o� ��, <br /> Fee <br /> S iTr �iS�FC,C.�'i� �'` . /i <br /> Dafe <br /> DEPT. APPROVALS <br /> Remarkc Enginecrs•�-�- �� � �������7� <br /> Walcr <br /> � )7rr: �- . - - <br /> — Strcel ` <br /> Communi alionz_�t�•'2^-:*. . . .. -� �'�-. . <br /> Traffi���"1: . - �, . .: _`�.! . <br /> Planning ,../� <br /> . . . '. 'lil � •� ��.,.�Ii �,I U�:�)f. �J�'t�5�3 F . �, . �.:� . _.. � <br /> 2A Ifours be(ore '���I'"�'��" <br /> , ; Mnshuction I <br /> `t'T. ,�(r,t � ;��-;-' is 5tafteA, i <br /> i r,c ,:t��:, i � <br /> � , _._ _ <br /> 7 <br />