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Hereby applies (or permission to <br /> J , � i/ � _ �.,�� , > <br /> � �� ._ _ `-�',- � . � �: r' r. <br /> At the following location <br /> '}� ` NOTE <br /> SKETCH r,�ir�i� ��;�iTH �^�nTFR <br /> IWorkto be done) �� � C'' �. ! ;R ',. '�.�: i? ; I'VE <br /> ic.. .,.r, C� � L(;�AIIUf�S Li�FCC� C?!.^AVATION <br /> .� � .. � , <br /> c' t� � � _— � �R�V10E fOR <br /> � ,.�- �;.J.i, ��. U:;,�,t..;'�GE <br /> � , <br /> � , <br /> � � <br /> '� —� � � � <br /> -- 1 - ._ __-- <br /> 5 �11 � r' ., <br /> w <br /> ° �' } �, .� �, <br /> r <br /> �� � � �' : =, <br /> n `'� <br /> --` --�— -- — - - - - ---��-� � l T � - �7� <br /> , 1 �_ U <br /> I ll . ' � Q <br /> � t � { _ <br /> b <br /> b Z <br /> � <br /> z <br /> i , ��. _ �a <br /> I <br /> Variance Required <br /> The undersigned owner hereby agrees lo hold ond save harmless thc Cily of Yes_._._._.__.__....... <br /> Everett from ony and all daims lor damages thal may arise because of the No..........._.....___.... <br /> inslallotion and maintenance of the improvement hereto applied for and <br /> further ogrees to remove same vpon notice from fhe City and to replace all �� <br /> public property damaged thereby. <br /> {,T�1, <br /> :,•`' �n�� � �� ' �" � �r / ..� <br /> � Signafure ol Applicanl <br /> ��o�� '�di' '�-� /� /j.- <br /> Address �� <br /> C7�"�i.�� <br /> ielephone Number <br /> /� Li��- ! � '��f�7_ <br /> / <br /> Da1e � <br /> -�� � - • / "--�`" � .. . <br /> � � ��,.,�r. � � - a�_6� <br /> �Inspecfois,Si nalure � <br /> ,:, L—I/l� <5f F� <br /> �- .z.� L`/� <br /> Dale <br /> DEPT. APPROVALS <br /> Engineer � ' <br /> Remarks Water <br /> Streel � <br /> Communicalions , <br /> Traffic <br /> Planning <br /> � � <br />