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1 <br />—' APPLICA1ION <br />I'GR ill; I <br />hf•OP-11AY <br />USE PERMIT <br />CITY LIJ(d I1i'Fl?S <br />L'vEnETT, ClA:;IIINGTON <br />PERMIT NO. r <br />The llndersig.etl _.•l�l%�9/-I,ai J t'r <br />Rntebyapplies forpermission to-,"'r+n�r:`;_;,�;'.--' f_� <br />�,�// r:•:v:/�iC T`-'___��1� __ <br />At the fullu�+im{ 11.cation—�',!. _. '17 ;L�r- <br />(Work to be done) <br />li u N t <br />,, J I 21 i! <br />T r''• ) <br />ORTEWAv SECTION <br />The on dersioned owner hereby agrees to hold and <br />NO SCALF <br />save harmless tl;c City of Everctt from any and all <br />-----"4 <br />claims for f!imagr.s that may arise because of installs• <br />t•--- l' LAP <br />tien and maintun-mca of the ImprJl' aenl hereto <br />—--1--== =-_ <br />--f <br />applied for and further agrees to rcmovo .ame upin <br />1-30' i —1 L30 <br />-0-f-------- 4 <br />notice Oum the City and to replace public property <br />' <br />damaged thereby. •7 -_--- <br />>,���I r.l_'_..+��' r _�_ ;'fps .� ,✓ <br />- _ <br />Sijmetu;e of A;,plicant <br />COPY s)P T'i;S APPL IChTII?;J 1'•] <br />Address <br />RE POSTLP ON .10!.y.I E, <br />I <br />Telephone Number <br />CALL LNhI'iC['!;C'.G fIFPT. "':- :;; f 1 <br />?A 1lot JI:B _E: P`i1i i.'Cr:3T! ,. .\ <br />Date '--- i5•r• 7 -- _- <br />CHEG'K- <br />1ii_;rl�obe— <br />.Dnpf. Approvals <br />l.ill.l }:. t:i ". 1: l �•"r <br />St,ret_.... ....... _._._ ..... . _.. .. _ <br />_ <br />�.I:I! •b a.l l Il.d:!IIIIi.._. ._._.�---_—. <br />7 <br />__. .._ <br />