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o I J <br />/p <br />9 2 vD <br />SP' 5 <br />41 1 2', <br />The undersigned owner hereby agrees to hold and save harmless the City of <br />Everett from any and nll 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.ftnature <br />Dale <br />T <br />Variance Required <br />Yes <br />No <br />Signature of Applicant <br />EVE4?c-cE&V µ/AV, <br />Address <br />Telephone Number <br />Date <br />S <br />Fee <br />DEPT. APPROVALS <br />Engineers <br />Water�"� cv- <br />Street <br />Communications <br />Traffic <br />Planning <br />