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Per:niY No.:.�. -L._.'�-"'_ �_-- <br />APPLICATIOt� FOR DRIVEWAY PERMIT <br />everett <br />QTY ENGINEERS �� / `� � `'� J����� <br />EVERETT, WASH. --' Approved ey <br />I�,�1 ��l� M/3.�.P. /%� <br />The Undersigned y�� � LL ;�ti, ( r QE Etil /-��i U C/� Datc Anproved <br />Hereby applies for permissien to <br />At the following location ���` M A n[� �� fi% __ <br />SKETCH I i- <br />IWoik to-be donel� --" - --- �� <br />B EvE R�Y <br />L�,Nf� <br />The undersigned owner hereby oc�rees fo hold and save hormless the Ci!y of Voriance Required <br />Everelf from any and all daims for damages that moy arise 6ecausc of thc Ycs _.. <br />. ._._.___.._.... <br />insfallalion and mointenance of Ihe improvement nr:reto app'.ied for and <br />further agrees fo remove same upon no�ice irom the Cily and to ;eplace nll No_...._._____........ <br />public property damaycd thcreby. <br />Inspectori Signolo�e <br />S/Tc£' C�/EC�Cr /i ��l//�7/ <br />Dale <br />C7F �/=.'.��.C,/c�?;� i'i?.• � <br />�Y� ,\R, <br />i3 t .; . �� <br />.;,<�;i` - � <br />. ��i,; l../'��7,�-�i: <br />x �� <br />�,�Gv,.C�°�����-,,.. <� �-:=1����.�,�� <br />Signafure of Applicanl <br />J _�// �1L.��G_..,,�- -: <br />Address <br />{ � � 3 - 7� �� /`' - <br />Telephone Number <br />Dafe <br />s �Jo Frr_- <br />F�� <br />DEPT. APPROVALS 7 <br />%"'' �i/`/- <br />Engi ncers,��-�C�G*�� <br />Water �• � , •. 7�, //- !I- ! 1 <br />Strcel � --�'� <br />Cor;cwnicc!ionr. � � ` _ <br />