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,_ <br />Permit No. � � . �._ � _- . <br />APPLICATION FCR DRIVEWAY PERMIT <br />� � <br />�__ ;:, <br />C(fY ENGINEERS . <br />EV[RETT, WASH. -. <br />The Undersigned_�F � - `. <br />Hereby applies for permission fo�. '� <br />At the fallowing locatian._ ' ` • �% ` <br />SKETCH <br />IWork fo be donel <br />9 <br />�. <br />� �S'�ll . , ,� <br />everett <br />� ''_' � ' . .-;�,��' - <br />� Approved By <br />�is_ i� �r'_�L <br />Dote Approved <br />The undcrsigned owr�cn c�reby agrecz to hold and save hormless Ihe Ciry oF <br />Everell from any and all claims lor damages ihat may nrise because of the <br />installation and maintenance of Ihc improvemcnt hcre�o applied for and <br />iurlher agrees lo removc zamc upon notice (rom the City and lo replace all <br />public property damoged thereby. <br />'i); ,S <br />Inspeclor's Signalure <br />�.�i/7-= -� �".C"-� `� � t —%/ <br />Dale <br />Variancc Required <br />Yes . .. _. . __.. <br />No... _..... ..... <br />r <br />- - I <br />. � <br />:,� - ��� /�, <br />, ' Signolure of Applican! � <br />,` % - <br />- <br />Address <br />Telephone Number <br />. ,',� 'y <br />Dafe <br />5 i�� �� l <br />Feo <br />DEPT.,PPPROVALS <br />yt �/.� <br />Enginecrs���� � f -' ��' /7� <br />'k� Walcr ./t ' � ' i__r %�. � i -_ <br />i <br />' Slrcel ..._._ <br />:�_.n:� � ��� �_ '.. _ _ _. . . __.___._ <br />