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. ���� <br />Permrt No..,=c _C-.--L--�r--- <br />CITY ENGINEERS <br />EVEkETT, WASIi. <br />The Undersigned <br />APPIICATiON FOR DRIVEWAY PERMIT <br />J,� <br />��` ° � ``'' "; '':��': <br />, ,. <br />3`„r. t;� ' �,°,; : <br />Hereby applies for permission tu r' ��� 51 � �� _' '. <br />Atthefollowinglocation ���v� ���l���cJ iU <br />SKETCH <br />(Work to be donel <br />�9 <br />i� <br />U/ r� <br />Thc ondcrsigned ownen c�rcby dgrees to hold and save harmless thc City of <br />Evereft from any and all claims�for damages that may arise becavse of Ihe <br />insfallotion and maiNenance of the improveme�l hcreto applicd (ar ond <br />further ogrces to �emove same upon notice irom ihe City and fo replace all <br />public property domagad thereby. <br />� w,: <br />. :.; ie'r:: <br />.:i:-a` <br />� 'l �i <br />. f�� �y <br />t <br />Inspeclor's $igno�ure <br />SiT� � f/iY . �� �'��2�7r <br />f•T <br />Dale <br />I��'7/.�/c� CU/NOLFT,F%� l3FrO�ci�_ PF_Fi�N//i N/A.S <br />Ren_,Ys <br />: -i/�� �n�"?L�''F!7 <br />everett <br />; ,. <br />����;� <br />�— Aoproved By <br />t/7i= C�!l1AF.E' ,Z3. %9%/ <br />Date Approved <br />,� <br />�"=c^' <br />.� - ,��� _�� _ _�i <br />� <br />Variance Required <br />Yes.. _.. _. _ ............._. <br />No... _. _.. _.... _..... _ _. <br />�, � � <br />��!'/��%l� � iG �. E �i <br />�� <br />` �,��,� M o rz R � <br />Signalure of Applicanf <br />�/�; C� ' M�/�i5n �tI <br />ada.e:s <br />Telephone Number <br />Dale <br />g 1�0 ��C <br />��. <br />� Fee <br />=.,��•' <br />DEPT. APPROVALS <br />-,�--1�' . '/ /y_ � <br />Engineers,,,'—�' � 2 7� <br />�+L Woter � ' �-'_ - r , % ' " ' � . <br />I Slrccl—� ._ --. -:.— --------�------ <br />