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L <br />i <br />tJnTE! Pos'r' -ro Crr <br />AP(r1oY (.. <br />S9Ct-v0 C.P-owan <br />2-4" <br />ACrSoUe ass%1.ovNb � y erJ CEIJTEZ <br />Zy'� w000Er.s <br />za' <br />co>T <br />I <br />� I <br />EXIST/h/�a �oM �. �. <br />• •tee <br />._ � w a • e <br />I_ <br />WNTF,;� G/NE.S!i <br />9TH <br />l <br />sT. M►.ay MArSDA�EN <br />Ro ADW A v <br />Gi <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 some upon notice from the City and to replace all <br />public property damaged thereby. <br />Inspector's Signature <br />LfrF C.y�c:��> 3-.5-7u <br />Date �'lr- r' <br />��LF..—LZ7ir1.E / iVL5`p4 <br />Remarks <br />�i=SPONS/R/L/TY Tn ��r�ry(✓'d� e5,7,t/p h�H,GY��CI <br />Call Engincering 0.p1. c:i9 t�3 P:L <br />24 hours before I , i <br />construclion f srucd <br />4� LuC4 i IL)*. R . '-i QiiE UCAVATIO14 <br />Va.ionce Required <br />Yes _. _.... _._.. <br />No.... .... . <br />zb` <br />Signature of Applicant <br />Address <br />? b^ s'- ' -n 2 / <br />telephone Number <br />/ — 77 <br />Date <br />Fee <br />•KO.4W <br />a <br />