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�. <br /> EVERETT, WASH. A oved By� <br /> � � _ Oc�bber �.9. �i�q <br /> � The Undersigned /'�'����+`�/r'✓`%'i''�� �wr�+:�.�%�'�. _ Da1e Approved <br /> Hereby applies for permission fo ��2,�,���'�� r _ <br /> At ihe following locotion_ �/ d �� �/L(1����lrr.f� :(S t-L/�i� __ <br /> .��.. ,. .._ _ _ .._ . ,,..kr......�.�,.. ..._-.-....,.�.�... <br /> SKETCH <br /> (Work to be donel <br /> 'he unde�signeu owner hereby agrees to hold and save harmles� ihe Cily o( Variancc Reyuired <br /> Everett (rom any u�iJ all claims for damages thal may arice because of the Ycs <br /> ........_...___.__.. <br /> installation and maimenance ol Ihe improvement herelo applied for and No. _._.__....... <br /> further agrees to remove same upon notice (rom the City and lo replace all � ����� <br /> public property dumaged thereby. <br /> ,w. <br /> ,-r. <br /> Y w <br /> ��� <br /> � r Signolure of Applicani <br /> r �z`/y/'''� `'/�`J�/2t'' - - <br /> ��" � . Address <br /> ielephone Number <br /> �'� '7 � Dafe <br /> ;.,�� ��i_Lf�-4> <br /> n7 spe�fo��i ture ` — $ <br /> � � ��� Fee <br /> Dol� <br /> DEPT. APPROVALS <br /> Remarks Engineer `�r ��n <br /> Water v � �— <br /> — Street <br /> � <br /> Comm o'��i'o�. a. . O ,f, <br /> �'4 <br /> Traffic <br /> Planning <br />