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Peimit No. �� - �� �..1.�`T.---- <br />APPLICATION FOR DRIVEWAY PERMIT <br />CIN ENGINEERS <br />EVERETT, WASH. <br />Thc Undersi,7ned ' ' , � ' <br />Hcreby applies (c� permissi,�n to ___ _�'� '__.—..� ' <br />; .� r � � y <br />Af the follov�ing location �' � __. � ' <br />SKE i CH <br />IWork to be donel <br />. . ":; ��-' ��, <br />1 '�1 �/JG.=� WNL,�v-11.� vL1g <br />Zb SE 1NSTALI�� AZ' BCJT',-� <br />0� FUT7JK�__�',��nIE�L <br />�� L� u�-�� '� � _ <br />�'�y- %.z i <br />c�322. ' <br />I <br />� —��. <br />J� <br />�J7 <br />f�� h <br />t. <br />4u`� <br />0 <br />4 <br />The undcrsigncd owner hereby ogrees io hold and save harmless Ihe City of <br />Everett Irom any and all claims (or damages Iha� may arise becnuse of the <br />installotion ond mainienance of the improvemenl hereto applied (or ard <br />further agrees lo remove same upon notice from Ihe City and lo replace aP <br />public properly damaged thereby. <br />`���SPcI `��/ � -7 -� <br />Inspeclor's Signolure <br />� / 7-!= �� r�i�t- , � l: t 1U � i -; �`_-, <br />Dale <br />,�1� �' '' <br />i. ,,,, I//-'✓7 L - ,. ,�7 �J�:.ilr,_ .. <br />„7�/V �p'C Y/C'i�,.__ <br />evercft <br />.� , , <br />'"y�-,�-, F. r1��-ti <br />Approved By � <br />� -�Z- 75 <br />Date Approved <br />W/ 1 T"F F= <br />�- VALVE <br />B�X <br />���///.�� <br />i .I <br />EXI577/,/C._ CtJ��?�; : <br />GU7-7Zr:�_ <br />Engin^crs <br />Water— <br />$Ircel _ <br />C.omm����� <br />�� <br />Vcriance Required <br />Yes <br />No <br />i �,� �..'ALE <br />_% . <br />Si3nalure o! Applicanf : � . <br />J <br />i , i r%�� <br />Ad�iest �; <br />� — -� � <br />Telephone Num6er <br />Fea <br />. /. . � . _. .. <br />DEPi. APPROVALS <br />�i�_ �'!/� f. - . ,% <br />.I.S:,.-.Yk � '�... <br />