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Permit No. .. <br />APPLICATION FOR DRIVEWAY PERMIT <br />CITY ENGINEERS <br />EVERETT, WASH. <br />everett <br />�,e� <br />Approved By <br />The Undersigned •DontsS <br />Ki02^Y"LjnsT <br />yn'l-ree-F'FL7SeS <br />1017,0 <br />Dale Approved <br />Hereby applies for permission to <br />SAVE <br />D2f'1JEruJAc`1 l.�l'i'h* .9SP11/1LT' <br />15 W 1 (]� <br />At the following location Izf 1 13�er f to �s T, <br />SKETCH <br />(Work to be done) <br />The undersigned owner hereby agrees to hold cnd save harmless the City of <br />Everett from any and all claims for damages that may arise because of the <br />installation and maintenance of the improvement hereto applied for and <br />further agrees to remove some upon notice from the City and to replace all <br />public property damaged thereby. <br />DRIVEWAY SECTION <br />NO SCALE <br />I's LIP <br />30"_j <br />rK <br />Inspector's Signature <br />Date <br />Remarks <br />s T. <br />Variance Required <br />Yes - <br />No _.... <br />Signature of Applicant <br />3 9 2-1 k/l `JL, <br />' &dress <br />�Liri-/9Gt/ <br />Telephone Number <br />Date <br />//Fee F— "- -m <br />7i <br />'�jDEPT, APPROVAL <br />S <br />Engineer!"—/ i <br />Water <br />Street n <br />CTraffic <br />calio_nsL4�re�r /72 <br />