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��/s <br />Gp¢ <br />r <br />--- , _ _ _ _; - - - <br />/,5' ' '. <br />GL.4 C ,�- <br />�_ <br />The undcrzigned owrcn c�reby ogrces to hold and savc harmless Ihe Cily of <br />Everett from any an•1 all doims !or damages Ihat mny arise because of thc <br />installation and maintenance of Ihe improvemeN hereto applicd ior and <br />(urlher agrces to remove same �pon noiice from the Cily ond lo reploce all <br />public property doma9ed Ihcreby. <br />� . <br />�� `y. z� � _ _ �. <br />I pecfoi s Si�rialure ' <br />i <br />,' <br />-� � s <br />� ' — <br />Dote <br />Variancc Requi:ed <br />Ycs <br />No <br />0 <br />✓ <br />(�� ..��1�'; y• i (.% , .. a. <br />� $ignalure of Applicanl ,� <br />.� � ( 0� �� �- ��� �. <br />ad�«,� <br />��� 3• % � •� <br />7eiephone Number <br />� <br />.:f : � .., j . j _ /,.•, <br />� � Dale <br />g ^ �_ ,�` ,__ <br />Fee <br />DEPT. APPROVALS <br />J <br />Engincers _ �.`'� �/• t'�� — <br />Water ' <br />Slmet - <br />Cammunicolions - �' '� � ' L`" � — <br />Tra((ic — <br />Planning <br />