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316 76TH PL SW 2016-01-01 MF Import
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316 76TH PL SW 2016-01-01 MF Import
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Last modified
11/27/2017 8:52:06 AM
Creation date
4/18/2017 10:26:21 AM
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Template:
Address Document
Street Name
76TH PL SW
Street Number
316
Imported From Microfiche
Yes
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IT MUINMZ) <br /> EVERUT, WASH. Approved By <br /> Thr: Undersigned Dare Approved <br /> - � <br /> Hereby applies for permission to <br /> At the following location 2 2 -7 G PL <br /> SKETCH I — <br /> (Work to be done) <br /> Q" <br /> . IV <br /> 76 7W _ _PG A CE REM 0 V eRE,tWAjC-0' <br /> �� LoNL• CdRA <br /> ger <br /> ASP O.ei &'W4 YS - <br /> Z10 <br /> 9 g I 6 \ <br /> The undersigned owner hereby agrees to hold and save hr mless the City of Variance Required <br /> Everett from any and all claims for damages that may mise 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. , f <br /> 1� <br /> Signature of Applicant <br /> ?6 1e2 ( ,4-S C/4 efiI <br /> Address <br /> 444 3 -84v 9 cue AA 9-GA6,G <br /> Telephone Number <br /> s—r-A y / 270 <br /> Dale <br /> Inspe-.lois Signature _$ 2 1 5-0 <br /> Fee <br /> Date 3' 18 /uJ <br /> DEPT. APPROV LS _ 00 (o <br /> Remorks Engineers ArO <br /> Water <br /> Street - 1 — <br /> Communications .fi I .i .1/ <br /> Traffic <br /> Planning <br />
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