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EVERETT, WASH. <br />The Undersigned � <br />Hereby applies for permission to_ <br />Af the following location <br />SKETCH <br />lWork to be done <br />' TVQTE <br />CHcCI< �NITH 14ATFF <br />C'?T. FOR VJATER L <br />I_CC�tllC1S C�EFORE <br />PROVID[ FOR <br />PRO,"cR DRAIhJAGI <br />' . , _ ' : l.-: <br />�' � <br />- - � � .. ,�_ _ <br />Approved By <br />/�r i7'��G`.�' C� /�%� <br />Date Approved <br />� <br />The undersigned owner hereby agreet to hold and savc hormless Ihe Cily of <br />Everett Irom any and all claims (or damages thot may arise 6ecouse of the <br />installation and main{enance of Ihc improvemenl hcreto applied {or ond <br />further agrees ro remove same upon no�ice from the City and io replace oll <br />public properly damaged Ihcreby. <br />ii ei W Ew,1Y. .:. 56C <br />c�n _ 5����� <br />of^�„ _ �� , <br />!-'' il�r.�P <br />y�q�. �s,�. � _, _ . , . � .. . - <br />Inspecloi s Signalurc <br />?/TE �H.r`G'.�ElJ ��� /�`' <br />Date <br />�i�,r�. . <br />,�Nca. r-Nc�in'r_r:� in�C D<`/'7 <br />� DRIVE\JF.Y.-S4CTlON..--- <br />,I� � � <br />� Lo �O J—__' <br />— `-- <br />,,,_,_�_� �_---- - <br />- _.___ ` <br />+ � m�� _ _'� _.__�. `•.cvL :, <br />�---^,____ � 0 � a M1 I E) _—` <br />�� ' <br />- �i s�F��' .-'�1Hoeerzs gEFOK6 Cc,,;..; ,. . , .�� � i <br />_�7f1 r7 f= '. <br />I , ,}0 <br />Variance Required <br />Ye;.._ ..._.._.._...... <br />No__.._ ..._._......_.. <br />7/�i�B�7 ��h' ,�7N�'�, <br />�y 16 ��'� o a,o ula i <br />.� / �i <br />�� Signal e o pp icanl' n� � <br />�3'//� ,B�2o9.�t!/fI'% <br />Address !� - ri <br />���� - (�� 5 �/� <br />ielephone Number <br />, ,/�/?C, <br />� < <br />Dalc �_. <br />/C�} � ��� <br />i <br />s � z " �� �'u <br />Fec <br />DCPi. �PPROVALS <br />F:ngincern'rj '�'��/=L�" � C/�/jc' <br />Watcr � :�..�,:..n7 /�'- �. . ��� <br />Sfreet � <br />Communicolions� ��-" , �-- <br />Traffic <br />Flannin� . �N� <br />