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. - ,� . ,� , <br />Permit No. _�' �-'_(..'...f . ._ <br />AFPLICATION FOR DRlVEWAY PERMI7 <br />� <br />CITY ENGI�.EERS � � ' <br />�, -=�s�� -r-�� <br />EVERETT, W.^SH. Approved By <br />I,/'�/ ����� .�g , �'>i <br />'�''', l��V ���'"/��.%'!"-� patc Approved <br />The Unde�.igneo__� �–� • � �"" — <br />Hereby applies for permission to �'-^�� - �' - J' ' � •� �� �"L—�� ('_ � -�� ���. ! /l � =`'' ��-�' — <br />At the following <br />SKETCH <br />IWork tn be de�el <br />� <br />� � ��. -v �v.D <br />�.. ,. �. , <br />The undersigned ownen c�reby agrces �o hold and iave harmless �he Ci�y of Variancc Required <br />Everett from any and all claims for damages thal may arise because of the Yes .. _.... <br />installalion and moinlenance of ihc improvemenl hereto applied (or and No .. <br />further ngrees to amove same upan notice (rom Ihe City ond lo replace all <br />public property donaged Ihcreby. <br />.`•�iS�:� <br />Lispecfor's $ignolure <br />-�/Tr �N r' c/7 � _.Z(, - %i <br />Dafe <br />Remarks <br />�, i <br />. . ... , %'.:..,r: ir,..�.. <br />S�gnalurc of Applicanl <br />1 � <br />/ � � / •� <br />Address <br />' ; :�t _ ,•�':� <br />' Telephonc Number <br />�i�._. i - ! / <br />Date <br />S,1 I� �. i._ �.. <br />I_� <br />Fec <br />DFPi. APPROV,ALS <br />� / <br />l Engincers•. . � / �<-.% _ ���/T� <br />G& WnlCr�t—�'.�.� L—_ <br />%' checl . — _ . _ _ . . . -�_ <br />