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- �in/� / /�'�'?� <br />lhe Undersigned�G_.L'�� �— ��/�' LC�� � Date Approved <br />tiereby applies for permission to � � �� � � —� "'` , �' "� <br />.—.._ r <br />At the following location > �� �—��' �� ' ��' -- <br />SKETC� <br />IWorl�ta be donel <br />m <br />� <br />�� <br />/ <br />< <br />�► <br />� <br />� <br />5 I `' T <br />PL. <br />` ONC K�.r T�: <br />- CuRt3 <br />The undersigned owner hereby agrees to hold and save harmless the Cily of <br />Everett frcrt�, any and all cloims for damages that may orise because of Ihe <br />installation and maintenance of �he improvement hereto opplied for and <br />furlher agreex to remove same upon notice from the Cily and to replace all <br />public property damaged thereby. <br />,��� <br />G�'��L <br />2 <br />��Ir✓1,/ ��•� <br />g� �� <br />Inspecfor's $ignalure <br />._ S �r.iEC.��� E' /��.� <br />Dafe <br />Filii <br />._.._� i „.,,,._ <br />_...._._ . . _�----- � <br />7 <br />_ r� <br />T, :'4 _ • <br />S <br />! �= 4u <br />Variance Required <br />Yes..._........__._..... <br />No. _...__......_..._... <br />W. <br />���'/ L.''''�E-G-C / <br />i <br />- ignafure oF Applicant <br />.�'�-.� '% — /�,`��.� � <br />_��G`v-c-� <br />ielephone Number^ <br />.- f�3 -yy 1 �' <br />/%P'P�c �' ' ,'� <br />� � <br />s �a °.._- _ ".�, ,,� <br />Fee <br />DEPT. APPROVALS <br />1/�j / <br />Engincr.:s_ �����l7ft�`±%� �'//%`d--� <br />Waler ' "�'/t i / � T <br />Streel - — <br />Communicalions ��" �-..,.`r-�-�.`-''�^-�"�.--�... <br />Traf(ic a�% � - � . � 7 � I�". <br />Planning � � � <br />i '!-`. <br />, - r. y:!-fl: .'hTLii <br />I:..,�T. I�i`n '':I�i ctt !-i'�.;_ <br />1..:�.'i{C�P;t :'.. ''R� EXCAVATiON <br />C��� . �:Ti�.�.. ! . _.... _.. <br />„�,,,. <br />T� n,;.�: : ,. <br />, <br />MI�! � �. ��!:.. i�: �1,:i1�;:. <br />