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EVERETT, WASH. h¢sroved By <br />`Q �o9_ <br />The Undersigned C QATlttes( MoRR1S Defe Approved <br />Hereby applies for permission to ar w,,0-17�Yr A an, ASPS- —r-%c- Conk Q6T E <br />At the following <br />SKETCH <br />(Walk to be done) <br />s <br />�7514 <br /><—M-- —4 --j' CLEARANCE MOM P/L REQUIRE0 <br />The undersigned owner hereby agrees to hold and save harmless the City of <br />Everett from any and all claims for damages that may arise because of the <br />installation and maintenance of the improvement hereto applied for and <br />further agrees to remove same upon notice from the City and to replace all <br />public property damaged thereby. <br />i <br />Inspector's--.!;Jnalure <br />Dole <br />(-,I//' 1, (.. Y. <br />4t- <br />Variance Required <br />Yes ...... .... _.... <br />No <br />P Signature of Applicant <br />E <br />Engineers <br />Water <br />Street <br />Communications <br />Traffic <br />Planning <br />Address <br />A <br />Telephone Number <br />Date <br />Fee <br />DEPT. APPROVALS <br />APPROVED '/' /)0 <br />CI NGINECR <br />