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EVERETT, WASH. <br />Approved By <br />� S�-���,tir3E�_,��: �T� <br />The Undersigned .�F-�FA/ �/Ilc�%' �'�-AA2 D Dare Approved� <br />� <br />Herebyappliesforpermissionto. �'�'�� A y ADb1Tf0rJ oitlTO ,Y/.�'-�T DiE'� <br />At the following lo�ation �p �.-� "`J Z�'" `s!- <br />SKETCH <br />fWork to be donel <br />1 <br />V <br />i <br />The undersigned owner hereby agrees to hold and save harmless the City of <br />Everetl fr�m any and all claims for damages fhat may arise becau:e of the <br />insfallotion and maintenance of the iinprovement herelo applied for and <br />further agrees to remove same upon notice from the City and to replace all <br />public proper�y damaged thereby. <br />i� F �+:SY. �-_:_.SCC.TlQM <br />(N�O:`:-SCAL�� � , <br />�� ; { 3a� <br />..�� <br />p�::,:..�.......,.__ _. ; _� <br />� ( i <br />�1.._- _ �i,.. �.<� ��— <br />�+ -- -�-- - <br />)nspedoi s SignaNre <br />�:r� ;vr--c«r� 9/.,� ��, <br />Dafe <br />�' - L � � -----.__._-- <br />� I�i:U,��IIJL 1 OI� <br />�� PiiUi'�F; ORAINAGE <br />i� I <br />� <br />,... . _..._____—_._ .. <br />. __"_—____._.. _.__..__ ... .. . <br />J�ND �T <br />Variance Requiied <br />Yes. _ ........ .... _ _... .... <br />No_........ _........ _... _. <br />1" i�'. I�, %iJ I/,� i/��� G' l�C. � s:'+`a;���Y�� <br />�� ,f; 1 (':�.,� �"�. �� <br />Signaf re of Applicani j, <br />.� �J �. X '� �-1"''...� <br />Addrest <br />✓ ,� r _� <br />�� .�n � / ,� `�- "�- <br />RJTelephone Num6er <br />Dafe <br />s U2� " ' y-9- �! <br />Fee <br />DEPT. APPROVALS <br />Enyineers _��L <br />Waler i:��t T /I� 9-13-7/ <br />$t fee I .�,..__v.N-....e.-..—.1.,— <br />Communications �'X �' '�=—�'�' ` � '`-r <br />;�arr:� ��r d� y-�� 7/ <br />Yi • /r <br />Planning _ <br />' �!O'i`t. L'all ,�.'ngire3ring (iep(. :'.'�9 ��:J3 <br />CHECK WITti WATER %� Houfs be(ore <br />DtP7. FOR WATER uNE ; COtlShUCiin11 is started, <br />� I,QCATIONS 6EFORE EY.CAVATION <br />*�--..�.._.__ __�._.. , ._ . <br />.._ <br />_� <br />