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Permit Nc. __.... <br />UTY EIJGINEERS <br />EVEREfT, WASH. <br />� <br />AFPLICATION FOR DRIVEWAY PERMIT <br />% <br />The Undersigned �!" �� / ' ' • , � <br />Hereby applies for permission to --� -���� � <br />At the following location��� i� l`�� • _ <br />SKETCH <br />fWork to be donel <br />W <br />� <br />O <br />c <br />� <br />J <br />Thc undcrzigned owmn c�reby agrees Io hold and save harmless Ihe City of <br />Everet� irum any and all cloims for domages Ihat may arise becauze of the <br />installation and maintenance of Ihe improvement hereto applied for and <br />furlher ag�ces to remove same upon notice from �he Cily and ro replace all <br />public proprrly damaged Ihereby. <br />_ . , , . _ _. :,-m . yi. <br />h <br />� <br />� <br />everett <br />a � <br />t� . <br />rored By <br />T l�. � tD, 1q �g <br />Date� <br />° n�oTE <br />�„-.,: ,.�rry �e,qTER <br />11' a-.-R �_INE <br />L�,c.;.... . . ;-;_;�� _ EXrAVAT10N <br />PRO'lIDE FOR <br />PROi=ER D;<<,l;�:AGE <br />Variancc Required <br />Yes .._... _.._... __. <br />No._...._. _..._. <br />n> <br />�.., i <br />/ / <br />�z .� r� ; �. . . s,_/;. � , <br />Signa ure o Applicanl -�- -- <br />°'� / <br />V <br />,�,/. �.3,.•,l d�:t. �, <br />Address <br />j: ��/- G: /d :JL. <br />Tefephone Number <br />/ <br />•-. % .7 ��; Dafe <br />��y.. ,, , - _ _ , r : � ; <br />