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�� �/ � �j <br /> Permit iJo. -'-,�•.i-_...�,.---------- EVeI'E'tt <br /> APPLICl�TION FOR DRIVEWAY PERMIT <br /> CITY ENGINEERS � y � �? �_ <br /> EVERETT, WASH. Approved By <br /> M �.�,�.� � %47/ <br /> The Undersigned / '1 f1 1C1 c�'�, � � e 1 I� �J Darc Approved <br /> f <br /> Hereby applies for permission to_� ��c.t '�' Q �� � r� � <br /> At the following location_ ��(7 �;�L� <br /> SKETCH <br /> IWork to oe donel <br /> M cz J r, O I � q � •) l- , <br /> -- _ _ __ �. <br /> I-- <br /> v�q�w <br /> � il <br /> � � Iyu � <br /> VS' <br /> �� � �il_ .��11 <br /> I � '�.l '��� �x I � � <br /> � I <br /> i <br /> I Ii <br /> I � I L� <br /> Thc vndersigned owncn c�reby agrees to hold and save harmless Ihe Cily o( Variance Required <br /> Everelf from any and all claims (or damages that may arise because o( the Yes. <br /> __.....__...._....... <br /> installation and maintenance o( the improvemenl hereto applied far and <br /> (urther agrees lo remove same upon notice from the Ci�y and �o replace all No_._......__...._....._. <br /> public pioperly damayed fhereby. <br /> _>rF=i�'J <br /> QRSY.E�+nY: --secrioH <br /> � . <br /> (t�tO_..�SCARE'� `�G�� !`�:�!'�:7� ! .. �.;':(,f'..� <br /> � Signafure of Applicanl� <br /> tr.iu�=;� ,_.�,_ �:___ -�� �/�J %�?c�c,�',.�'-t;� ,�` �_,�. <br /> �+,f �,Y;� -----� � € � !�_(.,'�y Ad�ess <br /> �.�— �� y� <br /> . � 3��- �;�.�J <br /> Tr.lephone Number <br /> ._.._..._....� <br /> _. r .C'�,�-- — oa�� . <br /> '--=- <br /> � ,u �;. <br /> Inspect s Sig�clure $ ;� �'%� <br /> 1 — b — /� �lt. �/LGG'.[%cC Fee <br /> Dafe <br /> D'cPT. APPROVALS <br /> Remarks <br /> �nginecr: <br /> Waler�— � � <br /> , ___ _ Streel � <br /> � C,rmn�,,,i�iUJ'i;.-�,.._—_—____— . ._ <br />