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Pcrmit No.' _ .. .. :. _ �. � <br />APPLICATION FOR DRIVEWAY PERMIT <br />,� <br />� <br />CITY ENGINEERS ' <br />EVERETT, W:�SH. � ; <br />Thc Undersigned��L' � � � <br />Hereby applies for permission to.�__'_ <br />At fhe follo�ving location <br />SKETCH <br />IWork to be donel <br />everett <br />` ' ����' <br />�. <br />r `_ ' l�t � . <br />- App�oved By <br />q�.iL /��, /��7/ <br />Date Appwved <br />- �i:� . <br />� — <br />I q- <br />The undersigned owner hereby agrecs to hold and save harm�esz �he City o( <br />Everett from any and all claims for damages Ihat moy orise because of the <br />inslallo�ion and mainlenance of Ihc improvemenl hereto applied :or ond <br />furiher ag�ees lo remove same upon no�ice from �he Ci�y and to replace oll <br />public property damaged th^•eby. <br />Inspeclor's $ignalurc <br />.._� G ��.,c�=� -� /G -7i <br />ooie <br />�; < / <br />� <br />i < ;l <br />1 t.-J . )' �� <br />, , <br />� Variance� equired ! <br />,! Ycs . . . .. . _.... � <br />�' No . ....._ , <br />i <br />� i <br />i <br />i�,-. � � <br />. Signafurc of Applicanf <br />� � . <br />� Address - <br />� Telephone Number <br />Dale <br />S r l' i� % � � <br />Fce <br />UEPT. APPROVAL$ <br />Enginccrc� ��� /�!�/.'.L��.�=✓ ��//�i <br />� Water ' �° +"-._ rj • � �" � 7 1 <br />Slrr•� • . __ _ _ .. . <br />