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� <br />ETT, WASI i. <br />The Undersigned � ' <br />Hereby applies for permission to <br />At the following location <br />SKETCH <br />IWork to be donel <br />_ — %n„ <br />� � `G <br />b <br />�1� q40 <br />��1� Q'9� <br />3� �o �s <br />, / L Sse . <br />�MyS 4..i <br />�� � <br />i <br />/ <br />/: <br />� <br />• � <br />/ �w i <br />` Cyl <br />� � <br />/ <br />/ �1, � / <br />� � /�� � \ <br />i <br />/ - / : <br />/ � �% � <br /><,, / / <br />� y. <br />O / > <br />� v ;�/ O <br />� <br />�'� <br />i � �` � <br />� <br />% <br />� - � <br />The undersigned owner hereby agrecs to hold and save armless Ihe City o! <br />Everett from any and all daims for damages that may rise Lecause of Ihc - <br />installalion and maintenancc of thc improvement her lo applicd for and .. <br />furfher agree: ro remove same upon nolice from ihe jly and to reploce oll , <br />public property damaged thereby. / <br />m � �. <br />11 j� <br />\ � <br />\ -_ <br />.:.J;,O � l m __ 1 <br />d OI ' <br />� <br />Intpecfor's Signafure <br />Dale <br />.; Q? i_i �. ) <br />Approved By <br />Dale Approved <br />__, , , , <br />� <br />� <br />Variance Required <br />Ycs _ . ......._._.... <br />No _ <br />/ �� � / � <br />Signalu�e ti( I mnf <br />��> >z ���k�f�//� ,- <br />Address <br />�/ "i – 3 I 2 2 — <br />ielephone Number <br />� 2z/ �% <br />Dafe <br />$ <br />Fee <br />DEPT. APPROVALS <br />Enginecr � - <br />Water � e�r< /• 2 •-""1/ <br />StreM ' <br />Communicalions — <br />Traffic_ <br />Plnnning _ <br />