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Permit No. l ''' � <br />_ ...,.Cl`_ - �... .- - <br />CI'�Y tNGINEERS <br />EVERETT, WASH. <br />�;P�'LI�.:ATION FOR DRIVEWAY 5JF_�?�MIT <br />; r.>. <br />.i;' <br />� f` <br />everett <br />,�//' �.c �� %. �. <br />� �.�i!'./�-,. f <br />� Approved By <br />. � �i�� �� � , - <br />^ �, �/ � . t/�O)..'_' <br />The Undersigned _ �-- � � - `�' t ; � � �- � ��� n' {'v1 I L �. � _ Date Approved <br />Hereby applies for permission to � nU �'i�', �_ (� ;'�_�} �, r+�%) 4� � t:;1�tt � _ <br />At the following location_ % l7I /t� (� c� 1 t�. (J t f <br />SKETCH <br />IWork to be donel <br />I 23 I 2 2 <br />� �J�x <br />Pdl ^v N�f`vrc� <br />_ eNt�e ��(� t;rr�rK)o��I <br />The undersigned owner hereby agrces to hold and savr hormless the City of <br />Everett from any and all cluimt (or damages that may arise bncause of the <br />insfallalion and maim�aance of fhe improvement herelo applied for and <br />further agrees to remove ,o�ne upon notice from Ihe Cify and to replace all <br />public p�opaty damaged thcreby. <br />�H� v.E �✓�'+Y. ;_.. 5 tCT/ON <br />(uo-_-scnc�� <br />(�-E_a;ii_ `_�� _----._ ._��__-- tl <br />r� _ __ _ ,.� �,_ <br />� �-1__. '�� : -, -i-- <br />�- �;--�- , <br />In<peclor's Signafure <br />�i7-6 -i>i=�'"'.Cr:) ��''���ii <br />Dafc <br />��� '` : { <br />r �, <br />Variance Required <br />Ycs. .._ ___ _....__.... <br />No.. __ _.. _.. _ _.......... <br />c ^� ` 'f` <br />Sisnalure of Appliconf <br />.; . <br />Address <br />-.�-�`'�;� _ _,. <br />Telephone Num6er —'/ <br />�, <br />i <br />� , , - <br />�' . <br />, Dafe <br />.. $ l�fn i��� <br />Fee <br />DEPT. APPROVALS <br />i / <br />i ,� _ i , <br />Fnginccrs --�-- �� � ��-� - '� � � � ��% <br />�� f / ;� � !'r <br />. �Nalcr -T��� ' 1 � 1 � ; � � �� �_ <br />� Sirect _G �� _ <br />� r .,.,.��..-�.icclio;.. . <br />