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EVERETT, WASH. L4 <br />Approved By <br />�1- <br />The Undersigned TrJTE A,4 T2/�o A16 LDate Approved <br />Hereby applies for permission to end 5 % L C / I �C ✓� �` ^/� i,/l L CL <br />At the following location d3 fL// ��� Q Vt <br />SKETCH f'/AAvT XA'E/f <br />(Work to be done) <br />•e I 2 <br />at <br />Ir <br />�. <br />`DhhW <br />,erAlA//,CMG WALL <br />RPf/AtG STALLS <br />4327 <br />'LAti17-ER AREA <br />/28.3r I IG <br />O <br />.¢ .47-.4 A l/c ti/C!E <br />The undersigned owner hereby agrees to hold and save harmless the City of <br />Everett from any and all claims for damages that may arise because of the <br />installation and maintenance of the improvement hereto applied for ano <br />further agrees to remove some upon notice from the City and to replace all <br />public property damaged thereby. <br />Signature <br />fir <br />Date <br />Remarks <br />C,gLA, �NG'iN��P/NG �cPT, <br />CDx"-'; el/GTidid /S' <br />CALf- <br />y" 4U <br />z::d,c/ry STD. COA_lc- 51W,, Cfc::� <br />OR J fle (A/AY <br />Variance Required <br />Yes _. ....... __..._.. <br />No _.__.....__..... <br />.. <br />Signature of Applicant A'at�l <br />Address((//�i�l(C <br />3 45 cs 1� aCN `Sol 71 f Telephone Number <br />Date <br />Fee <br />Water _A%_ <br />— Street ( <br />Communications <br />Planning <br />DEPT. <br />