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Permit No. a.._.....�. 2- J <br />CITY ENGINEERS <br />EVERETT, WASH. <br />The Undersigned --0E&I <br />APPLICATION FOR DRIVEWAY PERMIT <br />r <br />sr <br />everett <br />�ej <br />Approved By <br />J <br />Date Approved <br />Hereby applies for permission to-l'J S'Td t 3! o RI V L' wA�1 _ <br />At the following location 142 C-R 51 /v 0 4 0 0.1 14 '- <br />SKETCH <br />(Work to be done) <br />QRoFoai <br />R�w <br />C;-lUWH <br />CAStND RD <br />/NSrH4L /.2" CV4aEeLr- <br />The undersigned owner hereby agrees to hold and save harmless the City of <br />Everett from any and all claims for damages that may arise because of the <br />installation and maintenance of the improvement hereto applied for and <br />further agrees to remove same upon notice from the City and to replace all <br />public property domuged thereby. <br />DRIVEWAY SECTION <br />NO SCALE <br />I" LIP <br />0 <br />T 30 <br />30'� <br />Inspector's Sfgnah,re <br />LSMf r, D i <br />Date <br />1' To <br />CHS//VO 1'D. <br />.ach3¢ el llp <br />�vfiPfr// c.uti' 99ab/ <br />1\'tip .7 2 <br />Variance Required <br />Yes ............ . <br />No....... <br />'77 Mtv�. <br />�1 yLJ/ <br />;/Slgnolure of Applicant <br />Address <br />Telephone Number <br />Date <br />393n <br />Foe <br />DEPT. APPRQVALS <br />EngineelT <br />Y •ylo 1� -�Z <br />Wat<. iC A <br />-Street <br />Communicat's�M. .tw �,.�[�..• <br />Tfoff•_. _— --- <br />