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, ,i <br />Permit No. ",i <�..:�.-:...� � <br />CITY ENGINEERS <br />EVERETT, WASH. <br />The Undersigned <br />APPLICATION FOR DRIVEWAY PERMIT <br />Hereby applies for permission fo � <br />� <br />At the (ollowing lomtion �- � � - =1 <br />SKETCH <br />IWork to be donel <br />m <br />� I <br />-. � <br />ov�� l <br />�`�� ; <br />�p ni�,`�E <br />`�� �0..� , <br />� .—�� ��cti1 � , ._;��. <br />7 ' <br />I.7S � /P. <br />�i <br />� <br />� iL <br />I P J C ! "^ <br />_� ' I <br />� __.iJ <br />The undersigned ownc� hereby agrees lo hold and save harmless Ihe Ci'y af <br />Everell (rom any and all cloims ior damages Ihot �iny arise becau�e ol the <br />irotollalion ond mainlcnunce o( Ihe improvement herelo applied lor and <br />further agrees lo remove same upon notice (rom the Ci�y ond to replace oll <br />public properiy damaged Ihereby. <br />( ��L � ( LL�C l� ��h�%�, <br />♦ / � . <br />( �. ... `[ � � <br />, _ i <br />i . <br />• � i : .� . <br />Inspecloi t Si�n lure � ' � <br />L'' <br />�� /LI <br />^/ l-' /✓ � <br />Dale <br />Remarkt <br />':` 2 <br />'�i <br />� <br />everett <br />�provcd B1� <br />� <br />M�u. �o. �qc�4 <br />Date Approved <br />Variance Required <br />Yes <br />No <br />// <br />�— Signafure o( Applican <br />Address <br />Telephono Numher <br />Daln <br />S <br />Fee <br />DEPT. APPROVALS <br />Engineers` � <br />Wa�er <br />Sh�cl __ <br />