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EVERETT, WASH. Approved 01 <br /> Dote Approved <br /> The Undersigned - <br /> ! i r <br /> Hereby applies for permission to115 <br /> At the following location �Un <br /> — f--1 ` • Y—� - 7(r r_ P <br /> SKETCH <br /> (Work to be done) `— <br /> 7PI; ?%PI <br /> Rre iovc emr)otC4GE ; <br /> _a:;a-�`_-:_-` — .res• Jr' <br /> AS SWAY 5 \ <br /> e <br /> 1 <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 same upon notice bom the City and to replace all <br /> public property damaged )hereby. <br /> Signoturq of Applicant <br /> ��(, /.� AAs C y4ay! /a• <br /> Address <br /> Telephone Number <br /> Dole <br /> Inspoclur's Signature ---�—� 5 <br /> r Fee <br /> 3- f 9 D�uJ <br /> Dore ----------- A _ 00 <br /> DEPT. APPROV IS <br /> f'ngineen; <br /> Romer f ' water 6 <br /> _ Street_ - — �•'�� -- <br /> -" Communications.ri.�.+-_r�-/-i-f-}-- <br /> Trullir —•-- <br /> Plonninn _— <br /> r k <br /> s <br />