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Pennit No. _ _......_._ _ __ <br />a <br />CITY ENGINFERS �. y <br />EVERETT, WASH, c� <br />The <br />APPLICATION FOR DRIVEWAY PERMIT <br />-,: <br />Hereby applies for permission to ' •� + <br />At the following location <br />SKETCH <br />IWork fo be donel <br />� <br />_� �'—..�'---- <br />\� <br />everet�t ,� <br />r <br />e`�--.i���fc= =� <br />� Approved By <br />• / <br />�'�� �� � <br />oa�� Approved <br />''\ <br />The undersigned ownr hereby agrees lo hold and save harmless the City of <br />Everelt from any and all claims lor damages thal may arise because ol the <br />insfallalion and moinfenance of ihe improvemc�t hcrefo applicd lor ond <br />furlher agrees la remove some upon no�ice from ihe Cily and to reploce all <br />public properly dnmaged Ihereby. <br />Inspecbr's Signafurc <br />_ ��T/� L_ / �.GG�,: _.'.% ','..., � �-i// <br />Dale <br />Remarks <br />� <br />�/oriance Required <br />Yes . .... _ ..... <br />IJo <br />' , �, <br />� / <br />,� � ,i.SL.� �. ��' _di(�' -%( L <br />Si�pplicanf <br />Gr}c'' i:�•':1 <br />- aad.e,: <br />.� . <br />Tclephone Number <br />Calo <br />b �, ('' f � / <br />Fee <br />DEPT. APPRO� S <br />,� / /' <br />Engineers 1... !�— /�'7�y t : " 7 /L' ��/ <br />•�Water�:'i. , , , �/� , ; i <br />. <br />Slii�:�!--'_'_--- -....------------ <br />