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CITI' E�JGIi�IEEF.S � . �
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<br /> EVERETT, Vv'ASH. Approved ey
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<br /> The Undersigned_ �-a�%:--'f'��.< � ,�/-��� Date Appmved
<br /> Hereby applies for permission to //.�,5'-�! -'— 2-v � 111;.•:+i� /�i�/df. /1//1 `/ ;:// T/�� G cJi2�
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<br /> At the following locafion �'��-fT— � � �i � " r -=r`�1`?KI/�ry C %
<br /> SKETCH
<br /> IWork to be done)
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<br /> The undersigned ownen c�reby ogrees to hold ond sove harmless Ihe Cily of Varionce Required
<br /> EvereY, from any ond all dairts for damages fhat may arise because ol the Ycs _ ....
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<br /> installation and maintenancr of fhe improvement herelo applied for and
<br /> furlher agrees to remove same upon notice from ihe Cily and fo reploce all No . . _. .... _.._. .
<br /> public property damaged Ihereby.
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<br /> L L e � $ignafure o1 Appliconf
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<br /> � � �� �"� Address�
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<br /> `L,� ry,�,,� ,7N1.a0�+�,41 Tclephonc Number
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<br /> �i�'le�� �''�D � ��rN-�+,s:_ Dale
<br /> Inspedor's $ignofure $ -��//) %�`:;�
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<br /> Fee
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<br /> DEPT. APPROVALS
<br /> , � .. , / ,
<br /> Remarks • Engineer��..?'��`����� �jT���"'`"-
<br /> v` Waler -
<br /> _ . Slreel �--------� ._... . _._-- - .
<br /> j Communimtions�; ...t� . .^��'-. `.�.�:..- "
<br /> � TraRic P'� " � ' o - �2•;- 1-�- �.
<br /> . Planning iZf�S. S- J_U—"T L..
<br /> � i'r:�VIC[ �fOR .._.. ' P+lC"7':.:
<br /> � .� „��I�ER DfjAlra,1GE �
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<br /> ',rER construct�.
<br /> FOR W� i�p i �.,r
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