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Permit fJo. ..�-r'.1.__�..�.='�.
<br /> 1 everett
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<br /> :; APPLICATION FOR DRIVEWAY PERMIT
<br /> CITY ENGINEERS ������
<br /> EVERETT, WASH. _ ' Approved By
<br /> c/i�i►o= ,�4 /970
<br /> The Undersigned J� -'GN G���`-�,r Date Approved
<br /> Hereby applies for permission to. G o N S T 2 2 � �21 v`L- �
<br /> At the following location 3�2 !��'�U'4,� �y"��
<br /> SKETCH �EGf�.�.�L�� %T /5 /LLE�DL '
<br /> (Work to be donel T`; o , . � � � � , , ,
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<br /> �" = 40 � , ��
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<br /> The undersigned owner hereby agree: to hold and save hormless Ihe City of Variance Required
<br /> Everetl {rom ony and oll daims for damages that moy arise betause of the Yes..
<br /> _..__ .. __.___. .
<br /> installaiicn and mairtlenonce of the improvemenl hereto opplied lor and No....
<br /> further agi�es ro remove same upon notice from the City and to reploce all -��----��� ��-��-�----�
<br /> pub�ic prope:ty damoged thereby. ?j� ��;
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<br /> � � Signafure ol Applicanf
<br /> -Ap -�9, ...__.. �30'',' _`�"�� ��J D j 1 -.Z D `C ,� �
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<br /> .- i���1.1 �_ _��:� � ✓ Address �-�,. �? . ,/:,
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<br /> Telephone Number
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<br /> � UOIB
<br /> Inspecror's Signalure F�OVIDE F�(Z ; ` /� � '�- Z`��L—
<br /> / PF+�OPER �RAINAGE Fce
<br /> S/T� CNCCK�"/.� ��"G/�LS
<br /> Dofe
<br /> DEPi. APPROVA 5
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<br /> Remarkc Engineers ' ����
<br /> Walcr � 7'- � �i;� . . _
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