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\ <br />; <br />EVERETT, WASH. <br />l <br />The Undersigned <br />Hereby applies for permission to—_ ' `' '' ''"� <br />� Approved By <br />�r-_:7,��i�2 ,2� /97D <br />Datc Approve <br />,-��, ..,�. �_ 1, <br />_ � _' —'_��_.��__.--- _. __ /'LV� .- <br />The undersigned owner hereby ayrees to hold and save harmless Ihe lity of <br />Everett from any and all claims f�r damages that may arise because of 1he <br />insfallorion and mainfenance of Ihe improvemenl herefo applied for and <br />furlher a{7rees to remove samc upon notice from ihe City and fo replace all <br />Y.��AY. �::.5¢CTIDIi <br />(3�iU'�-SCAL[) <br />J n <br />��b iL'r �:.7� � . _. . .- ,_ 30 <br />�.J n .......�...Y ' <br />_`\� <br />:.�.����F' t ) <br />• �. �...`.�....�� <br />Inspeclor's Signafure <br />S/Th= C��C-�,EJ �%�'3�O <br />ooie <br />Call Enginsering Dept. 259�8803 <br />24 Hours before <br />cronstruction is started. <br />_�fi I VEWttY _ SECTlCiM_": " <br />1���_ �� �� <br />� .� <br />, <br />._.__. �: b :. �.. _._... _..____�..�._—'-I. -�-t <br />_.__._ .... .... .__.'-.'--'._'-----'---'..-� <br />.�. . . _... . ? ,.. , _ _ _.. _.,!....� <br />Variance Required <br />Yes.._._....__...___... <br />No..._ _......._____.. <br />i � <br />i i . <br />�,• �� i�l, '�..� 1 .A �� I � �� �. <br />$ignalure of Applimnl , � <br />--, / <br />� ' ' _ Address �7=icii � N-�. �`i < <br />. ..._ _ � s.�+oe c r3 ol�-A, ,r, a � �/ b� ^// <br />� <br />��/�, „� -% � i � <br />(f�!n�.'��_$.ca�f�,. ielephone Number <br />1D - z 3-��� <br />Date <br />$ ;'n � !�p <br />7 <br />�?.) � �) <br />Fee <br />DEPT. APPROVALS <br />' NOTE <br />C!IECK WITFI WAl'ER <br />c. r�i. FOa WnTE;� Ut�E <br />Li c'` ; `::S I�'i'�RE EXCAVATION <br />PR041DE fOR <br />PROi'ER DRAINAGE <br />