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y I <br />ist <br />Ao rxAs.r_ <br />The undersigned owner hereby agrees to hold and save harmless the City of <br />Everett Iran any and all claims for damages that may arise because of the <br />installation snd 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 />SacnoN <br />(t'JC SCAL -) .ui�ivC:`:IAY SLC•i IDN. <br />.r <br />f. n�,i �J �•. rc.l.t ___. <br />.I-TI�dA113 <br />Inspector's Signature <br />5/ff '.Eke/J 11,5171 _ <br />Dale <br />Call Engineering Dept. 2598803 <br />24 Hours before <br />construction is sbrfed. <br />PROVIDE FOR <br />i-NOPEI� URAINAGE <br />I <br />Variance Required <br />Yes <br />No <br />Signature of Applicant <br />Address <br />5sC, 77e/, c/ <br />Telephone Number <br />/7/ <br />Dale <br />r� <br />$ 0 4we /1r317/ <br />Fee <br />DEPT. APPROVALS <br />Engineers <br />�,�s Water <br />Street <br />Commu„acsiaa, ' — .., 14 = . <br />Traffic <br />Planning <br />r! TE <br />GK WITH WATER <br />1 OR WATER LINE <br />r:.rIONS 13FFORE EXCAVATION <br />