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FVERETi, WASf1. <br />The Undersigned <br />Hereby applies for permission <br />A1 the following locafion <br />t _ <br />�_ — <br />_ - �. <br />-- approved ey — — -- <br />�._. . <br />f��" ' '�._%i7J�,,`✓ �1 /`%; / <br />Jate Approved <br />The undersigned owner h:reby agrees to hold and save harmless the City of Variance Required <br />Everelt irom any and all claims for damages lhaf may arise bemuse of the Yez. <br />_ .__.....__. ........ <br />instollation and mainlenance ol the improvemenl hereto opplied for and No.... <br />(urther agrees lo remove same upon nolice from the Cily and to replace all � �± -��------ -��-���--�� <br />public property damaged fhereby. -; �) �' � <br />.J�R fV�,�/nY, _ SEC710N_:�� " <br />. <br />'—'-- S{ <br />� ,. . ..� <br />�"^.._.. t . .. <br />.-_.._..._ _.—____�_�.. �'__'____ <br />___ -- ___ <br />..._.. � _._.. _... � , ,"r:# <br />' �- �....._._.__ �_J� <br />� <br />Inspeclor'x Signalure <br />�'� <br />� <br />.S'� F' �. ,vt=C.c'fi� " � /7i <br />Dale <br />Remarks <br />C�II _n�ineering D2pL 'L59 8003 <br />?4 liours E�elore <br />��nstruction is staried, <br />l.fi�.�AY. �:.-. SHC <br />(N�O.:�SCAt.) <br />n <br />� � <br />vi •'; ....__..._......—� =.ti <br />. ,� _, . <br />' ` -- <br />� d,.._�_� _,.. _� � .� .-_ <br />" r��oTE <br />c:�r_,;� wir�i �+���rFk <br />'=�'r. ro� „a�T��:r, ur�r- <br />�, �. ,-�i�-�,,_ _ <br />, ,:;. <br />- ::XCq;�,iTiC. <br />��1 /, <br />� �n �,.�/ ��--1 �. <br />_ i'�c�:'.[.(!�' f'/V f r^ ��.��<✓/`.�-�1 V <br />Signafure of Applicanf <br />����� �l_�! .�, �C/� <br />add,e,5 <br />�.�� = �/7�/�' <br />ielepho,ie Number <br />�•,.�� ��� f� J� <br />(� ,�— <br />i� pp Dafe <br />5 - ��� �_ ��z._-�./ ; , �; ��i7 <br />_— .1�Y� <br />Fee <br />DEPT. APPROVALS <br />Wafer <br />$treel. <br />Traf(ic f�K r:�. l�t <br />Planning % <br />PkOVIDE fOR <br />PRUPER DRAiPdAG� <br />.o <br />%� <br />