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� 2 � '� <br />Permil No. ��k:r � . �..... <br />APPLICATION FOR DRIVEWAY PERMIT <br />everett <br />� <br />QTY ENGINEERS �~���� ✓ /. / <br />t t- <br />EVERETT, W/\SH. Approved By <br />C l('� % 2 �1�'/�/ <br />The Undersigned_�� � %� . � ��gyL �at Ae pp�o�ed _ <br />Hereby applies for permission to � � h st" r uc �� � i t��_Zi� �� n t��l R �rio i� I �< .� � X r/ $� <br />At the followin� location �n 5 2�f_ i� �i �,"l� '�S � v ri . <br />SKETCH <br />IWork fo be done) <br />/0 9 <br />Ib5Z8 <br />I I I <br />i <br />( I <br />\ i <br />.� <br />; <br />�— - � � ---- I_d+s�6+.�:�%w�ari�i' <br />C3everCy Q�v�l, <br />The undcrsigned owner hereby agrecs ro hold and sove harmlest the City of <br />Everetl Irom ony and all claims for damages ihaf may arise 6ecause of Ih� <br />inslalla�ion and maintenance of the improvement herefo applied for and <br />(uriher ogrees lo remove same upon notice from Ihe City ond lo replace all <br />public property damaged Ihereby. <br />Inzpecfor's Signolure <br />_ � iTn_' � Ni� ..(;t=l� �-30 7/ <br />Dale <br />Vminnce Required <br />Ycs ._ _.._._....._.. <br />No.... .... ...._. <br />1 J-,Kp P�F.�� <br />l i�l ��/�r � �( �«�� _� rrr � �v t�. <br />% Signalure of Applica�l —� <br />/ 1 ` � <br />-- (� �� � ��J �-� �.� f ,�� <br />aad.e:, <br />�i�.��'.�r'7' �C/.%�. <br />ielrphone Number <br />Dufe <br />S /1/O /=,E.E <br />Fcc <br />DEPT. APPROVALS <br />J�n / <br />Enc�incers il�rt`-/�'��'I � ���/� <br />Watcr "''� -----' — <br />