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,i>� .� � <br />Permit Na _ ':;!�:^ �� • <br />• - '-t___... <br />CITY ENGINEERS <br />EVERETT, WASH. <br />APPLICATION FOR DRIVEWAY PERMIT <br />�; .��, � �, , <br />a.�, ,. <br />, ,� r � <br />ev�rett <br />,. / <br />r� ��`� � <br />�-- Approved By <br />� ( ����i N f3 !��� <br />The Undersigned�kj (�y� � �( .�"1 f 1 f) � h Date Approved <br />Hereby applies for permission to �(1 �i �`� Q C'1 '� 1,� �"�,Q N p� /l f�� � S( Gt1 <br />At the followiny leration_�_ /�.( (Y� ! F, f? I.F _ <br />SKETCH <br />(Work to be dore) <br />�, �i <br />l_ (�, <br />�� <br />�"� � c� 15 0 I,t <br />0 <br />The undersigned owner �ereby agrees io hold ond save harmless Ihe Ci:s of <br />Everett irom any end ail claims for damages that may arise 6ecause o( �he <br />installation and maintenance of tVic improvement hereto opplied for and <br />further agrees to remove same upon notice from the City and lo replace all <br />public property damagxd thereby. <br />� `" 1� . <br />InspeUor's SignofureV <br />. � i i F' c �%�:: �: :�'r �'7 %i� / <br />Dafe <br />s�. <br />F_�,ce p�ion� <br />Varionce Required <br />Ycs_..... _.. _... _ _... _... <br />No... _ .............. _.. .... <br />���G ^'' I + ' .� ,�- - '! r�( � <br />. /- r 'G / '//'I.wX-'Cl' <br />' t�,<,r. SignaWre ol Applicanl <br />.._..?.,'.;,.. <br />� �/o 11,��-�-�.. <br />Address <br />.'•� <br />J�� �'��r��G <br />.s:_'.�. ielephone Number <br />� �3— � / <br />Date <br />Fce <br />DEPT. APPROVALS � <br />�.� �i � <br />Enginecrs = .�t. �.,�� � � r'�3�f/ <br />._.Water_;;��� . . . � � - -- -- <br />i <br />Streot '" —�-'--�------��------ <br />