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- i/ „ <br />. r-, <br />..-� , , . �� � <br />� . i .�' <br />, � , <br />Pe�md No. . - ' - � - ..� <br />APPLICATIOh! FOR DRIVEWAY PERMIT <br />CITY ENGINEERS <br />EVERE?T, WASH. <br />The Ur�c;crsigned= � <br />Hereby applies for permission to ' �%'' - <br />At the following <br />SKETCH <br />(Work to be donel _ _ _ <br />��� <br />.: • _ , <br />��� � �;'-: ;�/ , <br />./I/l,4 � /s � iv <br />The undersigned owner hereby ogreez lo hold and savc harmicss Ihe City of <br />EvereR irom any and all claims fer damayes thaf may arise uecause of Ihe <br />instollation and maiNrnancc of ihc improvement herefo applied for and <br />furlher agrees fo rer�ove same upen notice .`roe; the City and lo reploce all <br />public property damagcd Ihereby. <br />� � - / <br />1.� � � i`- ' i �-�,, , �_�... �Lc-.-s <br />/ InspeUor's Signature �' <br />/ <br />/ � / � �, <br />Dafe <br />Q VEI�/U� <br />everett <br />� <br />� -�.ti �C:�,_ <br />P�o�ed ey <br />�,�;;1 '.z.cl- .1 a �_ <br />Date Approved <br />� Ji'�j <br />Variance Required <br />Yes_.---___ ._ _..._... <br />No.._ .. .. ..... ....._.... <br />r' :- l <br />// . <br />Signolure of Applicanf -' <br />/ C �' � �J i l"�1 /� / ', d / L' <br />Address <br />ti � <br />'3��,i�= <br />Telephone Number <br />��.'ic'r � �7- _ -- ��� �^_� <br />Dafe <br />Fee <br />DEPT. APPkOVAL` <br />Engineer <br />� i �'� <br />V�'oler�, <br />Slr •t — <br />C,: r�. . .. .-. _ _ ._ ... <br />