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� Approved By <br /> EVERETT, WASH. <br /> . <br /> C7i�"i/f - -.�'i- /��/i <br /> Date Approved <br /> The Undersigned r � ' � � �' ` F <br /> Hereby applies for permission fo�"� ' ' � �� <br /> At the following locatioi� '_ � -' � I'� 1 �--r ' � � r � � P� it' <br /> SKETCH <br /> lWark to be donel <br /> �� �� � � �.;' � � � �� p '�,_�Ji_� . <br /> --- __ — ��;�:r�' -- <br /> - �— -� . . . - � i —::o. . <br /> i <br /> `s i <br /> I ^ <br /> I n , <br /> 28e8 y � <br /> I _ vti I <br /> i � <br /> ��=4° I <br /> ���. � pp �� ��' � j <br /> — - --- - -_ � � ; _-----— ���, I C:, <br /> l <br /> � ! <br /> ► <br /> � . � <br /> , <br /> � ; � <br /> � -_ <br /> Variance Required <br /> The undersigned owner hereby agrees to hold and save harmless the Ci1y o( Yes_. ._....__. <br /> Everefl from any and all daims for damages thot may orise becouse oi thr. �- ���-�-�` <br /> insfallelion and mainlenance of 1he improvemenl herMo applied for and No _ ._ ..... ...__.. <br /> further agrees to remove same upon nolice from the City and lo replace all <br /> public properiy damaged thereby. <br /> ----�--- <br /> j DRlyewAY: . ..StC210N <br /> I (iJ�� "SCALP.� � <br /> , C. c��, � l —o ( Iz <br /> Signafure of Applicanl <br /> ': k Ro" 3 J •�' 3 c>5j ,�/0�' S.C1.1 . _�w, <br /> ; -;�''_�._,__ .... __. __ .r� <br /> ; ! _ `. -- Address <br /> i �'�Y:..�__-�.::� ,� _�'l� - Z(-I 9 <br /> 1 ielephone Number <br /> �^_ �{- �'.4- i'/ <br /> Dofe � <br /> s � r "�—� .. �/Yr�"� l% <br /> Inspedoi s Signalure I �^� <br /> Fee �� <br /> . SITF ��,/i=l'F'E/� ��'r�7% — <br /> Dale <br /> DEPT. �PPROVALS . <br /> _ 1,�'/^' � � ^ � ` `'� ��'� <br /> Remarks Enginee�'c- r���-� 4' 7 '�' 7 i <br /> Water <br /> SlrceN. .�.----- ---- ---__ __ <br /> Communicaliops����'"''�� ' "-�^� <br /> Trai(ic -�`"r' �" � <br /> Plonning l' ff ` <br /> Call EnFineering Dept. '�5`.3��fi0'�� <br /> 24 Nours before ; P;;pVlnr F�� "-�� ' NJ i E <br /> conslruclion IS S�ZItCd. ; ��..� �- CkiCCK NlITH 1V�1i::i� <br /> � �.�.F�ft ORtUt�AGE os::�r. ro� wnrEF; � ��.. <br /> :� LOC1�7�I(;?JG EGFORt I g��qVAi'.;�^. <br /> i — <br />