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E`�'�RFTT, WASH. ` APproved By _ <br /> -1.r„ `.,'.i![iG� ._'' �;�'_ <br /> The Undersigned '�t��J �`-� '"'1'� • �������•f �'.� � Date Approved <br /> Hereby applies for permission to � �� �� T i`- ' r'` � l--t S ��"� - ! "i <br /> At the following location_�% � � `�$' � 1� �f�� �~�/ � <br /> SKETCH <br /> (Work to be donel <br /> � 5���� i , •._ ����C. <br /> �� - - — - ���- - — —� - - <br /> t-n�c oe PnJ'Tl`��f /„� -- -_ = _ <br /> - -- - -- -� ��_.�'� � �__ <br /> � ; <br /> ; <br /> � ��� , <br /> � , _� <br /> ! ����31� <br /> �J <,� � <br /> f�<� . <br /> ��,_,�._� � <br /> � `�7 = a / <br /> uf <br /> M � <br /> , <br /> , <br /> The undersigned owner herc6y agrees to hold and sove harmless the City of Voriance Required <br /> Everett from any and oll daims for dameges Ihat may arise because u( ihe Yes. . . . <br /> _.._. _. .._.._. <br /> installotion ond mainlenonce of thc improvement herefo applied for and No.._. <br /> further agrees ro remove same upon notice from ihe City and fo reploce aU � �� - �� � <br /> publi: properfy damoged Ihereby. <br /> � <br /> DRIVEWAY SECTION i�1 � � ��� � , <br /> ��jALE� � Signalure ol Applitanl <br /> / <br /> I LIP I� � � � ��- I�J v <br /> Addresr <br /> �� � <br /> j�30 ►� �Ta3� ��� - ���� � <br /> Telephone Number <br /> —:.2- �z- �� <br /> � � y Dafe � �� <br /> ��isJ nF��"_Z�-� J GG:.-�70LL J �� �f ,L_ /, ,:_; <br /> Inspecfor�nalure � .' f. .� � S // � �L�� <br /> � `�,` %i <br /> i.� _ , <br /> ; ,- I `" . . . � '- Fee <br /> �;�� � % ,• ,c.',� 1 �';-.'.-. F'i�i � Cj` �I� � /�7 <br /> Dafe � <br /> �l �/ , / DEPT. APPROVALS <br /> ^-�'l' ,�lIGJ`' �.+n�-�.?.i�li�� :;�G!CT �( L.l���9 � ....L/ L .,:,.�-� � <br /> � �� Enginecrs <br /> Remarks ' <br /> .0 Waler L� '�� ���' <br /> �l�l� ' w � {� <br /> i'.Ldi/./✓ . Strccr � <br /> Communicalion5 � � <br /> Tmffic �:' � ' " Lar��-c d'/,�4- <br /> , <br /> Planning". i/ i' �,-,,.�J :'{�.�-:,� =%:. <br /> � <br /> � . ����, :�r��. � :.�H�CI; VJITM 'WAItH � � <br /> . i} �,.�. i. . ��. UEi'r, rnu �11FR LINE . <br /> � . .�t- �I211Ed. �OCt�iir7 � r_.,;:,: � �'^n�ralli�W ' <br /> .—.--- �-- ---_ .. .. __ .�a.i. <br /> 0 <br />