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EVEP,ETT, WASI i.' � � A.pp����ed R�
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<br /> / � I L n j,��r� Dale Approved
<br /> The Undersigned �L- �--
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<br /> Hereby applies for permission to— •
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<br /> At the following location "
<br /> SKETCH
<br /> IWork to be donel
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<br /> The undersigned ownen c�reby agrees to ho�d and save harmless the City of Variance Required
<br /> Everett from any and oll daims for damages Ihat may arise becouse of thc Yes. . __._..... _ ......
<br /> inslallation and mainte�ance o( the improvement hereln opplied for and No . . ..._. . . _... .
<br /> further agrees to remove same upon nolice from the Cily and to replace all
<br /> public proper�y damaged thereby.
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<br /> DRIVEYlAY SECTION �. '.� ' { ?%���e ,�, =/:.tC�,��
<br /> NO SCALE SignaWre of Applicanf
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<br /> i" U P Address � �
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<br /> ielephone Number �
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<br /> � Dafe
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<br /> Insp� Signalure $ ��� � ,��/ �I� i/ '¢
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<br /> OEPT APPROV S
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<br /> Remarks Wa1er `��� __
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<br /> 2A Hours be(ore r N�L'K .,�� � �' �
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