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F.VER'tTT WASH. Approved 'dy <br />� - <br />�, .��— <br />� ��i.� ;��r� � i %"!- � <br />� , � � � Dole Approved <br />� f.��' 1�_ _ � f. <br />.:i r,_� ,.0 <br />The llndersigned � - ' - `` — <br />� <br />, �� . <br />�� � � ��- -��- j)- :,=� ... 1 J <br />Hereby applies for permission to �`� h�, 5" �� ��- � `' ' - - <br />�._J , ��' i4 i7 t�11'f f� � 1_ yr, !: <br />—1 , ,_ f.., ; . , - <br />�3 o I '' �', � � �� --'`�- 2 �.,� - , .. - ) <br />At the following !ocation `� — <br />SKETCH <br />IWork to be done) <br />No <br />S-GA L� <br />\\ <br />The under3igned owner hereby agrees to hold and zave harmless fhe City of <br />Eve:ett from any and all claims for damages that may arise because of the <br />in;tallalion and mainlenance of ihe improven•enl hereto applied for and <br />further agrees fo remove same upon nolice irom Ihe Cily and to replace r,il <br />public prop�:rty damaged Ihereby. <br />Inspecfor's Sign� e <br />DRIVFWAY S[CTION <br />NO SCALE �,.�` u <br />L <br />_.�_�3 ��` <br />_5.� ''/� � / '��-�.1 <br />� � ��- .�-� <br />Uale <br />i.a1l En�inee�in3 Cr.pL '1.`.�?�'�,°�' <br />z4 kiours belure <br />i0Il5iNCt1011 I`-� �t�f��3� <br />� <br />�IiGN vJonu <br />' i�1C1i E <br />Ci+tCCK WITW Wp"fER <br />' ri�R Y�A'ER LINE <br />' ��.PI� ��JS F2fJ �^���( FXrq��ATI��M1� <br />Variance Required <br />Yet _.. _.......... _ ..... _.. <br />No_. _. _ ............... _... <br />�' ) � ` � . . _ � <br />�.;�2�'..n c' i' t,. • Y� ti. '�`- <br />/ , -� � �?,. <br />1,c (:!'fN,.U.'.� , � . � {,�.. <br />/ <br />�' Signolure cl Applicant r <br />'� i''! <br />�`��r� r� ._'. : ' ?rr� �'C. �j' . <br />�h �� Ad�dress .�.. ,.++ 1 �%R/"Z <br />`_ l." .��:i: .�-7",n� <br />t:. �� - 4 � G�.J �' ��'��(Y � e'N� <br />ielephone Number C�L-c/,� Z � !,"i <br />� -r,r �-,:� <br />77 �� <br />� �-� .�? �,, q:� s � <br />�` ale <br />S ! �G' %� <br />�; � � Fee <br />i�� � C..'C �`-" /�-/'C c <br />s <br />.. l .,�. ._.-� 3 <br />DEPT. APPROVALS <br />�/ <br />.. . .� ✓'.�... jCGs�L�-•'t�- <br />Watet <br />Slreef. <br />Tra!fic <br />` <br />%r sv : .c/J�rir-x.irrr_.� - � - .r.�-� ) <br />�G`.�JIl�'t� .cG,•+ =,,::j%/;'�' !'G.;��u:`�iG:L� <br />/S Cy`-F :l'."�: <br />i .. <br />I �'�'OVICE FOR <br />IPROPER DRA;;•lP,GE <br />�. noco..�. <br />