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� . <br />_ ... <br />Pernnt No..-.... ....._7..._...... <br />APPLIC�.TION FOR DRIVEWAY PERMIT <br />everett <br />CITY ENGINEERS /_T�Lt���3'���' <br />EVERETT, WASH. ' "" Approved ey <br />�d.:.+-/B�� ,2.3/9�D <br />The Undersigned n��k MARTENS ('c�NST � owuER • pnRERi L. M FnDoR) Date Approved <br />Hereby applies for permission fo r.n�i s'rai�['T �- AsvNALT D�W's <br />At the following <br />SKETCH <br />IWork to be done) <br />�l0 SGA� � <br />The undersigned owner hereby a< <br />Everelt from any and all claims I <br />installation and maintenance of <br />.`urther agrees to remove m15� <br />public properly damaged Ihcreby. <br />30" <br />� <br />N <br />: .';... � - :. .4�.: e ." f'..71 e.i :'. ' <br />Y6'� J., <br />hhri� ' r <br />r <br />+' ,�: <br />x f:. a:, <br />` � �la`te <br />3a� <br />�fo hold and sare harmless the Cily of <br />damages Ihat may arise bec f-ihe <br />uomeM-t e o applied {or and <br />from the Cily and to replace all <br />MQ��;ivs�����Y:�s_crtov:_:. <br />!_...... _ �.-. -- =1 <br />? F ���) <br />.. ...!. . . ._.__ _._..�.�_. _.�„ _ � <br />d . .. _.._.. .. .'__._�_ e\.�/_\ 1 �"� <br />, ... r. __. _n__.j` . <br />� .�.�! .'..........__W._.._.�.�_�.._..�. <br />;?-��5.��.iR <br />Inspecfor's Si�nafure <br />Sir� C''�Ec��v ��� �T� <br />uate <br />//, <br />���i �) - . �. .. � � ., '� I ✓ f �. �%i G � <br />f'�=EwER �-""__ _"_ <br />r�,9,v77A� G p rJ <br />AR r� Ar� y <br />, <br />� ScwcR ` � �O� � <br />_�--��'__. '" �� <br />_ � <br />12" CULVBtaT` <br />�-�" <br />i�....��.. <br />Varinnce Required <br />~ [jCLO�GL'JHy <br />�ovTti <br />_ ... __ .__ __..._._.._..._....�.._..... <br />L'-.Fttve•:fln`:. -_�.�SGL`.T./ON <br />(r',i"? _"ufiACE� <br />� <br />c�ry p;�o� <br />��� <br />_' CJKi: <br />_ __-i <br />� �' �<<. u..<<�L;_� <br />Signafure of Applitanf -L <br />h . � n <br />�f, �C' 1 � <br />�'� � �% �, \,>�X \`F`l � /3 � <br />�_ . -- � � P, <br />_ ' . _ ^, F-._ __ _ __._ -,--�T� � <br />r Address <br />�' � �. _. ""__ { e _ .� _ � ` <br />g �1-1-Cc .,� � _ <br />( Tele�hone Number <br />........_...... .._�.._.__.._ _ .. _ __i �d/.Z�/ %�% <br />DOfo <br />� .- M� _n <br />e.Z r ... <br />S �%z � t'-�L <br />FBB <br />DEPT. APPROVALS <br />�, ,. <br />c"nginee� � - � / lJ <br />Water <br />��rcet_.-.:: !'h. _ : �<.1i_._i.__ �t�.. <br />