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� _ <br /> • --� R <br /> �.,..'t No. _—; �--' — . <br /> - - _- � ev�rEtl <br /> APPLiCATION FOR DRIVEWAY PERMIT I <br /> �� <br /> i <br /> ' `� �.����� i <br /> GTY ENGINEERS ; � i <br /> Eb'ERETT, WASH. '� Approved By I <br /> r <br /> �-,—o,�,�� l i9i'�D � <br /> The Undersigned <br /> �.� � ����_�i^f� Date Approved � <br /> liereby applics for permission fo ���ST�' [' .45�6���� P.41�/A/r �N �=-�? /�i � !� �1'%1'�T"" ' " ' <br /> i <br /> � � ' � 7 �S { �3 G s n Pa,:F �'o �rc,r ��)l� �� ��i�i� i <br /> At the following location �f `"� 3 � � L�Y f�t�E <br /> i <br /> i <br /> SKETCH �� �Z ! I � <br /> IWork to�be donel ' � �_�� <br /> � i _� <br /> 1� � � <br /> � s_ I <br /> y ..�.�r'' `' \ <br /> /� / I ' ��, <br /> � � � I <br /> ,S ����n�� �,�� � <br /> ljj t��o,r_� �_..,._..:. to --- W <br /> � LN�DL':^.��i� / / i��-; . <br /> � ����j7:� �� I t� .� �j v � � � <br /> �� <br /> , �� v.r. � r.P _ _�. <br /> Y — .'—� �o• -- <br /> ' � � � — <br /> _.�� ' � <br /> � ��,J `� '� �nlotr:: <br /> � � �'" �y�i7, s iy.---� �n��oSenPtNC <br /> ;�i 1���f � 70 <br /> � � P,P�J'OSF�) r��"/'f'. f'•1d���F oN G�T/ f..'���. <br /> v <br /> ' } `�E, TH .7T <br /> �, <br /> The undersigned ownen c�reby aorces to hold and sovc harmless Ihc Cily of Voriance Required <br /> Evcretl from any and all daims for damages that moy orise becavse ol Ihe ' <br /> Yes__._.........._._.... <br /> ins!illation and maintenonce oF fhc impmvemenf hereto applied for and <br /> lurthc� a�rces to iemove same upon nolice 6om ihe City and lo replace all No..__........____... <br /> public property damaged Ihcreby. <br /> , ' C% , G� ISoi7LRn/O <br /> � � <br /> x /l j' ,�/ri (�s��:l <br /> - Signalore o Applicanf � <br /> .��:�2 � �-'t'._'�d :i f�LriA/�/t.. <br /> S` =i 1 '� <br /> 'j C'^ � Address <br /> _ J�,,,-'- <br /> J%� � �� -,�� �: �. <br /> ^ ielephone Number <br /> + <br /> :5 � .-� _ �'Vi <br /> Dafe <br /> Inspector's Signafure � �� /—f-� <br /> Fee <br /> . S.7-F Gi��;�-�r� ���g�o <br /> Dafe <br /> DEPi. APPRQVALS <br /> �„' �� <br /> Remcrks Enginccrs = <br /> L �///7� <br /> Watcr v` " <br /> — Street C. _ E.{.d.. .. •- ,2-�.i <br /> Co:n...,�r.icctUcm.--._ � ____ _ � � <br />