Laserfiche WebLink
Permit No.�-=:_--r-.---';- , <br />G. <br />�:li i EF;GEt�:EcR;, <br />EV;EP.ETf, WASFi. <br />The Undersigned <br />Hereby applies for permission <br />� `.� -_ � _ . :^ � I , <br />At the following location <br />SY.ETCH <br />fWork to be donel <br />APPLICATIO!� FOR DRIVEWAY PERMIT <br />ti <br />73 =" <br />�' , ' .. <br />/ <br />ST,2cET <br />�2is <br />The undersigned owner hereby agrees Io hold and save hormless the City of <br />Everett from any and all daims for damages thof may arise becnuse of the <br />insrollation and -�aintenonce o( Ihc improvemenl hereto applied for and <br />fu�lher agreez �o remove same upon nolice !rom the City and lo replace all <br />pubdc properry damaged there6y. � <br />Inspeclor's Signafure <br />.>irlx i�F .r.F'n `��/ �, 7c7 <br />Dafe <br />kemarks <br />—' Ea'/ST <br />-' �, 1 <br />�� <br />� <br />� �� <br />i�.::'.�� � � <br />�l �EO.a.e Posr� ,ad� ,� o �=En/c�=, <br />!, /', <br />, <br />� <br />Approved By <br />Da1e <br />., � ,:, <br />%, � <br />6 ' ,yic, - � <br />Variance Required <br />Yes__..__.._.._._.... <br />No. . _. _.. _ _ _. _.__.... <br />1 <br />J <br />/ 1 � • iK <br />-�-y Signafure ol Appliconl � <br />/ , .:� /' ', � ;a l ,� l, ,, �:' ; , <br />� � -'- ',,7r ! •J <br />Telephone Num6er <br />�' % r�,i / � C, <br />/ Date <br />Ei <br />Fee <br />DEPT. APPROVALS <br />�-' ,`1'�/�^� /� �.-.'_i. / <br />n�inecis�..___.,1 __�„u� <br />