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Permit No..43.5./.5 .. <br />everett <br />APPLICATION FOR DRIVEWAY PERMIT <br />CITY ENGINEERS t. <br />' J i <br />EVERETT, WASH. Approved By <br />7 ,5Forr.MtW q i99D <br />The Unde•signed h%.,• /, r JiI�/rir Date Approved <br />Hereby applies for permission to ' M 4 S A), -'11bL ZA-, Co Ak! DP/ den-J,4 <br />fir✓ �iP��i'G�.�'T)/ L/i(/f <br />At the following location _sLL2- <br />SKETCH <br />(Work to be dotal <br />7s <br />1--50sRRAL A✓E <br />The undersigned owner hereby agrees to hold and save harmless the City of <br />Ever It 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 some upon notice from the City and to replace all <br />public property damaged thereby. <br />Inspector's Signature <br />Variance Required <br />Yes _. _........... <br />No__.._ ... _.. <br />' ignafure'o(AIS S1icant , <br />1,01 <br />d/3'A��t( <br />Af a277i <br />Telephone Number <br />i� <br />Date <br />Fee <br />DEPT. APPROVALS <br />Engineer W <br />.... I r <br />