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6415 BEVERLY BLVD 2016-01-01 MF Import
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6415 BEVERLY BLVD 2016-01-01 MF Import
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Last modified
5/12/2017 9:13:26 AM
Creation date
1/23/2017 1:04:05 PM
Metadata
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Template:
Address Document
Street Name
BEVERLY BLVD
Street Number
6415
Imported From Microfiche
Yes
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- � f^ r <br />� ,� <br />Pe.mit No... -' (' <br />�, <br />„ r_ <br />-f' � <br />�� '� <br />U <br />i?_ <br />CITY ENGINEERS '� � <br />,. <br />EVERETT, WASh. <br />The Undersigne.d <br />APPLICA'TION FOR DRIVEWAY PERMIT <br />everett <br />�������` <br />�' Approved By <br />�/7�,?i� ,��. . ��%%/� <br />Dole Approved <br />Hereby applies for permiss.on fo�NS%ALL S//��Ci��'�[� �Li� /GfT�/V % /�� i'�/�Cf'�'�ix�iS/ <br />Af the following localion �'��s � ��� ��'�- �� <br />SKETCH <br />IWork to be donel <br />3EJ. <br />5 <br />The undersigned owner hereby agrces lo hold and save narmles Ihe C�'y o( <br />tveretl (rom any and all claims for domages Ihat mn� a�ise 6�:cause of Ihe <br />inslallation and maintenance of thc improvemenl he��!o a:plied for and <br />furlher agrees to remove same upon noiice (rom the C ty o•d 'o replace all <br />puhlic property damaged thereby. <br />In!.pedor's Signolurc <br />� <br />`i/T.L< < f�/' ✓'/� i� i � '.�: /' 7/ <br />Dale <br />si��.� l�i.���_ r.�.✓sr��r�%� � ��:,Y��e� <br />Remarks <br />���" __��l?/�./,:.""i7 <br />8� � a <br />0'-- PRo/��se: ta <br />---,-- — <br />�!`� <br />,'�� <br />s' w�a� -��w <br />Variance Required <br />Yes . . ...._ _._.... <br />No. . . _.......... <br />i� <br />�� �' I/:1:" . L <br />/ _1 <br />, � , E �✓ �%.r,. • <br />��^y SignalurC� of Applicanl � • <br />( (_/ � `� (l�a . � iY"�} � �i f <br />E� <br />Add�est r <br />Telephone Numher <br />Dafe <br />b /t/0 ��� <br />Fce <br />DEPT. APPROVAL•�/ <br />'� �'� �1�2i�r <br />Engineer� �--'� ��:�ie.7l�'11_ <br />�V�/afcr� 4—' 1'� � <br />Slreel=,�L�__—' __--_—�,� . _ <br />
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