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Permit No. .7m�7© <br />APPLICATION FOR DRIVEWAY PERMIT <br />CITY ENGINEERS <br />EVERETT, WASH. <br />'r L <br />Approved By <br />The Undersigned Date Approvice <br />Hereby applies for permission <br />o6 e 99 /!E'T_ 4'IN5T�LL C1 -Z 57291V19AV) <br />At the following location — <br />SKETCH <br />(Work to be done) <br />BEVE RLY <br />LANE <br />ro <br />0 <br />�7 yErY 9• eiN Cn <br />EtreT y clw <br />ro x I •_ bo, <br />0 <br />fA <br />Q <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 />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 />Inspectors Signature <br />Date <br />Variance Required <br />yes- .......................... <br />No. ........................... <br />x ! <br />f/ <br />Signature of A plicant 61 <br />J� Address <br />Telephone Numberm <br />Date <br />$ LJ <br />Fee <br />Remarks <br />*Water <br />Street. <br />