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Permit No... ���?�''�_-------- <br />CITY ENGINEERS <br />EVER�, WASH. <br />The Undersigned <br />APPLIC�.TIOt� FOR DRIVEWAY PERMIT <br />>: <br />� � <br />�or�;; � f , �-_I ;�.�K�--r�'�nr:yt_- _� <br />Hereby applies for permission <br />At the following <br />SKETCH <br />IWork to be donel <br />n <br />� <br />�l 1 Q �15 a�t <br />?he undcrsigned owner hereby agrees lo hold and savc harmless Ihe City of <br />Everett irom any and all claims for damages that may arise because of the <br />insmllation and maintenonce of the improvement hereto opplied for and <br />further agr=es lo remove same upon nolice from the Cily and lo replace all <br />public property damaged Ihereby. <br />,:.. , <br />. .'. , <br />Inspeclor's Signature <br />/ <br />�iT�- / r/ -f'.c`�'_F_G� ��.%i "%/ <br />Dale <br />� <br />evereit <br />„ ,- <br />�%�':','.; %�,. <br />� _ <br />� Aaa�o�ed ey <br />�/lr'!S'� i' /G%7j <br />Date Approved � <br />� <br />� <br />Variance Required <br />Yes......._.._..... <br />No_.......__.__ <br />� f.. <br />�, /,_ <br />f <br />i ✓ �, �; �^�,� c., �. ,. /,.. � �l; <br />Signalure ol Applican <br />% n �L ��L -'s-t-��.J ,' — <br />� , aad,e:r <br />� -� <br />� _.� • - � <br />1 ielephone Num6er <br />l� ,, :i <br />� � �: <br />i <br />!j <br />� , y� Dafe <br />5 I\J O �C: F� <br />Fee <br />DEPT. APPROVALS <br />�/r/� .i / ,y <br />Enginecis-_ i�'l !fi. /= �, _ �� .;/ <br />G. <br />Waler i • , .TL'Git�� �/ ,-'r-� � fE <br />Sireet <br />�'lc:. i .G. ' <br />C:inrn�.�.,,f,nricr;. _.. --------'- �---"— <br />