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EVERETT, WASH. <br />The Undersigned <br />Approved By <br />����.ri7��F� � /i'%�5 <br />Date Approvcd <br />Hereby applies for permission to�'NJ T ,' - . _ � -`"�`�•f _ � �S. r✓�1.�' r) f" = "- — , ' ( , _'" <br />`�U��: i�_ �7i�/ r"�,,,,�-- ,..i ir � ji-.�— - ._ �'�.� �'`l . <br />/ � <br />Af the following lomtion ! � �� %C''� `� �—� �� <br />SKETCH <br />IWork to be donel <br />(1 � <br />,`JL'? L'c <br />; <br />� <br />The un,. _�:igned owner hereby ogrecs to hold and zave harmless Ihe Ciry of <br />Everett from any and all claims for damages that may arise becouse o( ihe <br />inslal�ation and maintenance of the improvement here�o applied for and <br />further agrees to remove same upon notice (rom the City and to replace all <br />public property domaged thereby. <br />i � -1 h � � � , , u� �s s/�a�,y /:,,, U<� � � :; � <br />Inspecfor's $ignature <br />�'T'.0 C'f/�`L:c�i7 c9//��X3 <br />Dale <br />/ ✓v/�..'� • . <br />�� k/D,L.�,(/ Lfi/�S , �'T./-�L-?i t=i <br />� \'c <br />< �' <br />� S�W JT <br />_� <br />�i / <br />� I— —"" �. <br />�"Q� QR A1I.�\�� I J i_ <br />I �3 2Cn <br />(� <br />�n�r 52 <br />�j.2 f� �,G,�->.''T A�t/i� l��V�.r.�i�JJ�c/S%YiF' <br />:��� • <br />_'..i .. <br />i � 1 <br />�1n�� - �� l <br />l�(J�,S �'F.�G�C{_� . s'i.�%cJi7A�t=Q� f�'JC�/1K' T_!�' _ ,:- <br />/���t/�' .a.c.=U.2E" �T s�"/ici_ �.= <br />Y � <br />/=;>C�.'�=i=-T,,,=`�� .� ;'�17' Gi,'�: <br />a <br />Cv �z.,S SiDE�•�a,.. ,, <br />Varionce Required <br />Yes .. ._ .._... . _.... <br />Na_.. ..__.__.._.... <br />f/ 7 /��� �/C._ il�e'(/iCC <br />� —;-:., <br />� <br />i(.T� C � �C � L l`f.�"' <br />,T fjgrfqiure of Applicanl <br />—r <br />�''X2�2 6� <br />S'.(,C���-G�t<S/1-�dreu G�j}f/� <br />� ;�,/7 <br />� �/.�/t! L- <br />Telephone Number <br />Dafe <br />s o� �, �— � �- <br />1�-� L' . . Fee <br />b-8- "�`3 <br />DEPT <br />�/� <br />Engineen'-��� %�. <br />Waler-==���� <br />srre�r � � <br />� <br />CommunicolioJ� "'� <br />Troffic lf- � i �" i <br />/ ��O <br />