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EV'ERETT, WASH. '' , -11 1.—,oved By �^� <br /> lho Undersigned .,•. %' Doe Approved <br /> Hereby applies for permission to efel zi' <br /> / ---At the following location <br /> SKETCH <br /> (Work to be done( <br /> CI 11.DEPT. i <br /> i <br /> LOCATION'S 131 )RE EXCAVATON <br /> i• <br /> 3, r <br /> NOTE <br /> CHECK WITH W kTER \ <br /> f)EFT. FOR WAT .R LIN <br /> �,OCl7i IGNS UE R5 (UAV.ATION <br /> The undersigned owner hereby agrees to hold and save harmless the City of Variance Required <br /> Everett from any and oil 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 notice from the City and to replace all <br /> public property damaged thereby. <br /> ti <br /> '•i/I G^ �`r Signoluro of Applicant <br /> Addreu <br /> Telephone Numher <br /> Data <br /> Inspectors Situ"— <br /> I <br /> Fee <br /> DOD <br /> DEPT. APPROVAIS <br /> Remarks ••---- —�-- Engineer <br /> Wa!er -- .•. �—�� <br /> Street--._..._.....,.___-._., <br /> Cnmmunicotions_..t`a.ir,_._,_::�:;:_—. <br /> Traffic <br /> ._. Planning <br /> a, <br /> v <br />