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— � <br />_ _- <br />Permit No. .._ _ ::...----'._..----- <br />APPLICATION FOR DRIVEWAY PERMIT <br />CITY ENGINEERS <br />EVERETT. WASH. <br />The Undeuignec� In/A i " _- <br />Herebyapp�iesforpermissionto!"n�'�T ? 5 5lo�s�A��c ora iTY PR�YF;2Ty <br />Af the following location_�7� 7– �� �L � Y �i �/�. <br />SKETCH _ , <br />IWork to be done) ' � ` ' <br />,'_ Lo <br />7_—_.�aJ--�,_ <br />I\�1 <br />The under,igned owner hereby agmes ro hold and save harmless the Gily of <br />Everett irom any and all claims for domages Ihot may arise because of the <br />installalion and main�enance of Ihe improvement hereto applied for and <br />further agrees �o remove same upon notice from Ihe City and to replace oll <br />public property damo�ed Ihereby. <br />Signafure <br />ss/iG � H�G,(: �.ii � ��8�%/ <br />Dale <br />Remorkz <br />evere�t <br />, � <br />,� ._�z� <br />'�� Approved By <br />��io/�/L ,2� /fr'%/ <br />Dale Approved <br />i <br />21 I 22 <br />23 <br />z4 <br />Voriancc Required <br />Yet_.. _ _.. _ _. _..... _... <br />No. _. .. _. _.. _. _... _.... <br />LLI <br />� <br />Q <br />�' <br />i+ . <br />° A <br />`�� ' . <br />Signalwe o/ Applimnl <br />!, <br />� . ,. . . <br />r ) f"� <br />�.)�` F i + Address '�. <br />"-' r - _- . � -- <br />7elephone Number <br />Dofe <br />b �i%) F(= <br />Fee <br />D7EPi. APPROVALS / <br />�Engineers � '" . �'�F'v/ <br />Wafer fi !<._.r!-,- , �f- i' <br />Sircet �' � <br />_ . . .rr .n -_ . <br />