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7 <br />/ <br />� <br />T -- � -. <br />� I <br />\ '� <br />.: � <br />Thc undersigned ownen c�reby agrec; to hold and savc harmless thc City o� <br />Everett from ony and all claims for damages thal may arise because of the <br />instr �:ation and maintenance of rhe improvement hereto applied for and <br />furlher agrees to rem:.v_ sam� �pa� nohce irom the Citv and to reploce all <br />public properly damagrd tl,^rcby. <br />/' �,�!- � '� �� <br />i, l, <br />�'�� , �v� �-� . <br />� � i�� —� r���� �. <br />, �, j � <br />�\l <br />Inspeclor's Signalurc <br />i_/ <br />� / i (,_ � �. i-'":"c.:.c.,� - ) . _ ,%�, .�'7, <br />Dafc <br />_ �,�,�.,_ .:���: <br />�:r:nstruction is started. <br />PPOVIi�,_ FOR <br />�> ,, � � ��n,irvncE <br />Voriancc Rcqoircd <br />Ycs <br />No <br />� . <br />� Signalurc oF Applimnf ~ <br />,-�1�D _ "').r_ ._ . <br />r.•„ - — <br />Address <br />. _ ,.- .� ; �:� <br />Telephone Numbcr <br />���C <br />S ' �` ` <br />�-,-. - <br />Fec <br />DEPT. APPROVALS <br /><y- � �/.� <br />Engineers - �� ,1" �z���-� <br />��Watcr� '�`- 1 /C-`�-7/ <br />_ ' Streel <br />Communimlions � " <br />Traffic � � � - _— <br />_ Planning `� <br />...- <br />;c� t � iH �;.� -•'� <br />(, �r-T for, ��r,���� utiE <br />� ��� �,,,r rxcr,:�.a7i� ' <br />_.._.__.._ � <br />