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<br />Permit No.,�^!._....,...:..............
<br />CITY ENGINiERS
<br />EVERETT, WASH.
<br />The Undersigned
<br />Hereby applies for permissiun
<br />APPLICATION FOR DRIYEWAY PERMIT
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<br />evere�t
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<br />p�o+ed By
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<br />Da Approved
<br />�t the following location � �
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<br />j SKETCH � N`�T�"
<br />IWork to be donel ••'-�� � �
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<br />The undersigned n.vner hereby agrees to hold ond save harmlcu �he Cily of
<br />Everell Irom any ond all claims for damages Ihot moy arise because �� Ihe
<br />insfallalion and maintenancc ol the improvemenl hcrc�o applicd for cnd
<br />(urlhcr ogrecs lo remove samc upon nolicc (rom ihc Ci�y and to replo;c all
<br />p�66c properiy damoged thcreby.
<br />Inspeclor's Signafure �
<br />Da�e "-� ------�
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<br />Voriancc Required
<br />Yes
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<br />,1 Signolure o/ Applicarll
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<br />�� Addrers � •�
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<br />Telephone Numba
<br />Dalo
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<br />fee
<br />D(PT. APPROVAt;
<br />Enginccrs r—
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