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Permit No..`:,...... .............. . <br />APPLICATION FOR DRIVEWAY PERMIT <br />J <br />CITY ENGINEERS <br />EVERETT, WASH. <br />The Undersigned ( `; C A N H I-'l r. t11 v r <br />Hereby applies for permission to r o A' -�T r' 17` "A ; G A y' r D/ W <br />At the following location <br />SKETCH <br />(Work to be <br />H <br />f�ISNL r� <br />L_ <br />2 <br />LL <br />_ <br />S TAT <br />S n <br />'uV E I .•- 40, <br />D15- <br />V <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 />installction and maintenance of the improvement hereto applied for and <br />further agrees to remove some upon nnt:ce from the City and to replace all <br />public property damaged thereby. <br />_... ...... <br />Inspector's Signature <br />i5S'c <br />/U <br />Date <br />Date <br />By <br />. A <br />Variance Pecluired <br />Yes..... _.............. _..... <br />No._..... _. _....__..... <br />Address <br />91 ILI S r. <br />Telephone Number <br />alLm 4y< i <br />Date it <br />$ <br />Fee <br />