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Permit No..� <br />APPLICATION FOR DRIVEWAY PERMIT <br />CITY ENGINEERS <br />EVERETT WASH <br />everett <br />�e� <br />Approved By <br />The Undersigned 4/'7NC3rL» '�(U �G.f'G / �C— Date Approved <br />Hereby applies for permission to G!l i <br />SKETCH <br />(Work to be done) <br />C D A R — -------&T <br />r <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 />inniallation and maintenance of the improvement hereto applied for and <br />further agrees to remove some upon notice from the City and to replace all <br />public property damaged thereby. <br />Inspector's Signature <br />Date <br />\� RPaA7,StA c-moyIT CROss/NG <br />3 ' w106 D►Tit: hd �— <br />t�/�1 TFiZ s�/ON5 <br />;383n <br />Variance Required <br />Yes _......_. <br />No_............_.. <br />Signature of Applicant <br />Or o (3 " ,F 2 L—; 771 0 X*s1, <br />Address <br />i�4- iac6 <br />Telephone Number <br />ate <br />Fee <br />DEPT. APPROVALS <br />Engineers— <br />Water / �— <br />Street r • �. J<u7,.... <br />Comm � ni,.ution s . <br />