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EVERET7, WASH. Approved By <br /> The Undersigned f-� E D i✓R I G `/J Date Approved <br /> C-P, AVEL- <br /> Hereby applies for pe,.nission to <br /> At the following location t' r T� -ST <br /> SKETCH <br /> (Work to be don I <br /> N� <br /> I <br /> ISN I - WffTErZ .SHUT OFf <br /> I T BE /PELOiCA7Z�!? <br /> h, <br /> PF /T /S W/T.�/ /ry rye OOP/l/E W,1Y ARE,+ <br /> j <br /> I <br /> lj <br /> l <br /> l � j r <br /> The undersigned owner hereby agrees to hold and save harmless the City of Variance Required <br /> Everett from any and all claims for damages that may arise because of the Yes _.. <br /> installation and maintenance of the improvement hereto applied for and No <br /> further agrees to remove some upon .iolice from the City and to repince all , <br /> public property dnmaged thereby. <br /> DRIVEWAY SECTION /. ,' Ye ' <br /> NO SCALE Signature of App,'icant <br /> 21 — -� 1t/ <br /> I" LIP Address <br /> r 3011 j -- — <br /> relephone Number <br /> /-/1 - 7s <br /> Date /D 3/—73 <br /> Inspector's Signature `�� " - S r��• ��---ate, <br /> e <br /> fN <br /> Date <br /> DPT. APPROVALS <br /> Remarks EngiMsrfC�� <br /> Water- <br /> Street <br /> ater L — '' S <br /> X Streel <br /> Commumcal'�M�j <br /> Traffic.- 5�.,i <br /> Planning <br /> t <br /> uta O. <br />