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:` <br />0 <br />� <br />� i�. <br />�,. <br />Permit No. .� _..� _�:._---�--- <br />APPL��ATION FOR DRIVEYVAY PERMIT <br />CITY ENGINEERS <br />EVERETT, WASH. <br />�verett <br />Approved By <br />The Undersigned_�y�LL ��AL%��� Dafe Approved <br />..i��.. . �� I/ . . _ . / � i/w.. / . ../i, i�.._ r— � i .....�.� ✓.-�. .��'-s�/ <br />Hereby applies for permission <br />.� 1 .... _ ._ /' i._ <br />At the following location 2s0 � B� ^�/�' �i A� <br />SKETCH <br />IWork to be done) <br />25T" sT <br />z'sa�� o� s�c�wA4� <br />REG'U6�T P�'2N1/55/o�'J To <br />INsrAG 4 7z "HicH c%f; ,�:t/ <br />t/�/K F'E/��c� <br />s�D� <br />� <br />n��� J 8LK 567 <br />G <br />> <br />V <br />V <br />y <br />r �, <br />The undcrsigned ownen c�reby agrees lo hold and save harmless the City of <br />EvcreB (rom any and all daims for damages that may orise because of the <br />instollalion and mainlenance o( fhe improvemenl hereto applied for and <br />further agrees Io remove same upon nolice from the Cily and lo replace all l <br />public property damaged fhereby. �/�� <br />, i�� <br />���� <br />PA^� <br />�'G� �a�'� <br />�� � <br />Inspeclor's $ignalure <br />Dole <br />Remarks <br />�G � <br />�� ��� <br />- ��,� <br />�� <br />�/N57.�t[. 'L.s �.:/rOc �',�:, r'_.��✓�, C•�'r✓c: J/J �/ <br />}.- zs � <br />�o <br />2y <br />Ze <br />3 <br />t� <br />C <br />Gl <br />� <br />� <br />r <br />Varionce Required <br />Yes..__..___........... <br />No....._ _.......___ _. _. <br />, <br />3r�;-„ �H�� VJP�LTL[::� <br />�-�„� '''�'f.��-=L <br />$ignalure`of Appliconl <br />z.�_, 7 Y i„_--..;...-.,,a�,,, <br />Address <br />F- �. .... " �� .. . <br />Telephone Number <br />Dale <br />��_�' ' � <br />5 ���. � s D�✓ <br />'''e � ... ._-'-> <br />DEPT. APPRUVALS <br />Engincers <br />Woler l f-"�.�� „'r""'=- — <br />Strect� , . �',. 6'i"w� `r,f, <br />i�- <br />�,:mrt_""'I.,,, . .. . _ �_ . <br />� <br />