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Permit No. / �—' . __� / <br />APPLICATION FOR DRIVEWAY PERM17 <br />CITY ENGIIJEtRS <br />EVERETT, WASH. <br />The Undersigned�� % �^ � / F <br />Hereby applies for permission to C� � �� %� � � �- T � _ - `'� ��/� <br />everett <br />� �,���� /, <br />c.�'G�,1" <br />Approved By <br />Fc= t3�'ilHh-' Y �� /�% <br />Date Approved <br />At fhe following location�� ��— �" �—�'-- �� .�L U U _ <br />SKETCH <br />(Work to be donel <br />/ ��:� <br />�� �� � <br />, c� <br />�— <br />The undcrsigned ownen c�reby agrecs lo hold and savc harmless Ihc Ci�y of <br />Everetl (rom any and all claims for damages that may arisc becausc of thc <br />inslallolion and moinfenonce o( the improvemenl herclo applicd lor ond <br />furlhcr agrecs to removc samc upon nolice (rom Ihc City and lo replace all <br />public properly damaged Ihereby. <br />�, <br />�� � �-, - ' . � • _.._.___._.. a � <br />_.��C__.__.._ <br />�!� 'r.� j: ,�.; le. S/ UF_ ll.�A/!` <br />��r ��� i, .. � <br />InspeUoi s Signafurc <br />,�/�'�:t-r[� '�//�`J%%C� <br />Dafe <br />. , �6�� <br />� rr <br />t� �" �,k <br />Q <br />�)f i��� <br />�,a��� <br />5/-�,. <br />��,,c� <br />Vuriance Required <br />Ycs . . _. . . . _... <br />No <br /><Y�-� G� y.4„r,� <br />,���, , , -. <br />, <br />' : �f .�'`:-it?'. L.C-"' — <br />�'$ignafure ol Applimnl <br />� � � f � /`�.+ /�i�.�...`� <br />' ndd,�:� <br />Telephone Number <br />`- :� �_�� ��'�L <br />oo��, <br />g l�D F�- � <br />Fec <br />DEP7'. APPROVA�S <br />� <br />Engincen'----� . <br />Walcr 7 _ � -�- !.� <br />Slrcet_ __ '_— �'_'— _. . _. <br />