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Thc Undersigned /
<br />Hereby ap,plies for permission
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<br />Af ihe following bcotion C��� /� �"�1'7�77a+a'/" —
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<br />Datc Approved
<br />SKETCH
<br />IWork to be donel �
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<br />— — 8� SEwER PiNE — ��
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<br />�ioT ro i3E /�/ L/NE I�TiL.E UNDEflnlE/�TM
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<br />The undcrsigned owner herchy oyrees to hoid ano savc harmlcss :hc Cily o!
<br />Everett from c y and all claims for Jamages thot may arise beccuse of Ihe
<br />inslallation aoJ mainlenantc of the improve�neN hcreto applicd for ond
<br />furlher agrees to remove same upon nolice frcm the City and lo reploce all
<br />public properly domaged ihcreby.
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<br />Voiicncc Requirrd
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<br />Address
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<br />ielephone Number
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<br />DEPT. AP�ROVALS
<br />Enginecrs
<br />Water � - • �.
<br />� Slrect " �.�: _ � :: - —
<br />Communimtions��_,���� ��.,r�'.�,
<br />r�arr� /i,:-r/.
<br />Planninp � �� �'� _
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