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The Undersigned — CJ J'9 C� _Dale Approved <br />Hereby applies for permission to ----.-- <br />At the following loca`ion Z L 0-i- `-- 7/ L/LP-ZAC-C <br />SKETCH t`I <br />(Work to be do el V <br />Q <br />J <br />The undersigned owner hereby agrees to hold and save ha:n�less the City of <br />Everett from any and all claims for damages that may arise because of the <br />installation and maintenance of the improiement hereto applied to- and <br />further agrees to remove some upon notice from the City and to replace all <br />public property damaged thereby. <br />QF iVifi%- AY 69—Cr 1OH <br />OVID SCALC) <br />Inspectc%s Signature <br />Date <br />Remarks <br />(;all Li netting Dept. 259-8803 <br />24 Hours More <br />construction is started. <br />PROVII)E FOR <br />PROPER DRAINAW— <br />IVCNJAY'_ SicTtoN <br />I i <br />Variance Regr.:ed <br />Yes <br />No <br />zt, . /1t .. r <br />Signature of Applicant <br />i d1 f- A•� a� I <br />zz IF26 S <br />Date <br />$ OD <br />Fee <br />DEPT. APPROVALS <br />Engineer �'/ 17, <br />Water —. — <br />Street -'"— <br />StreCommunications _ <br />Traffic t r t. — <br />Planning <br />N07E <br />I'LC K WITH WATER <br />'1 FOR WATER LINE <br />�t ; BEFORE EXCAVATION <br />