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Permif No. <br />CITY ENGINEERS <br />EVERETT, WASH. <br />The Undersigned � <br />Hereby applies for permission <br />; At the following location_ <br />I <br />' SKETCH <br />I IWork to be donel <br />0 <br />APPLICATION FOR DRIVEWAY PFRMIZ' <br />Thc undc�signed ownen c�reby agrces to hold and save harmless Ihe Ciiy of <br />Evereli from any and all claims far dumages that may orise bewuse o( ihc <br />insla!lalion and mainlenance of thc impwvemenl hcreto applied for and <br />further agrees lo remove same upon nolice (rom ihe City and to replace all <br />public properly damaged Ihcreby. <br />Inipeclor's Signature <br />T�rr / rf!-G�F�) `�"ti�" �� <br />Dare <br />/� lT� )%�7:=•'.� .�L.c' c i-�i(/i.%' <br />Remarks <br />I ' <br />everett <br />,� <br />��o,�/ <br />' Approved By <br />�P-fi/L � <br />Datc App oved <br />Variance Rcquired <br />Ycs <br />No <br />�l��t '-�/j��'Ll. ,i'G...���I _ <br />Signalure of Applicanl <br />. � <br />(„ �, J 5 � c c,-� � .,� �- i.if , <br />Addr ss <br />.� ��— ��/� `� ? <br />ielephone Number <br />Datc <br />b �� � /_� '� <br />Fee <br />DEPi. APPROVALS <br />� / i <br />_ ._..�.�.(ll�.c%'���Y�/'� �%/ <br />Ergincers <br />�Walcr�Tl.. n .., ii i � -; <br />c. <br />, . <br />..Irc.� - _. � ... _'_ ' <br />