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F:.rmit No. _f'_� _�'._ r_.... <br />APFLI:�ATION FOR DRIVEY✓AY PERMiT <br />everett <br />CITY ENGINEERS ° / <br />-= ��r ",.�'. <br />EVi:RETT, WASH. Approved By <br />' S:-vr.� f�B��' f`� /" <br />The Undersigned � �� • �� r �' �� � T?� r'1 Date Appruved � <br />Hereby upplies for permission to -�N � r �� �"' i;"�/ 5'7'f; ! 1 i71 �:�' % .S/67/ <br />� <br />At the follovring location �' ���` �"����%���� ST <br />SKETCH <br />IWork to be donel <br />C�pY <br />\T �-_. �- <br />V - <br />� "c U <br />o' <br />R OA D <br />I�✓OTL � <br />/t_ !n/,7r.-c? �!/lG1:!•^ /S r!�/T.,S!iiti/ <br />TffE' S/D/::'l�1�fI.4�� .rr'REA /T s�fC1U,cO <br />DE �j01/C/, T'� GY�TS/Ur ��GE <br />The undersigned owner hereby agrees to hold and save harmless Ihe Cily of <br />Everell from any and all claims for damoges thal may arise because oi Ihc <br />inslallation and maintenance of fhe improvement hereto applicd for and <br />further agrees to remove same upnn notice (rom the City and to reploce all <br />public properly damaged thereby. <br />i £ . � <br />Inspeclor's Signafure <br />_�iTi� �i-�fzC-�G.!E/� �/��7/ <br />Dn!e <br />,� ,J. V�e�ksfira"` <br />gDA' <br />� <br />� <br />Var�ance Required <br />Yes_ ___. _._........... <br />No.._ k. _ _..... <br />>��-� �� i� ��� r- ' <br />v <br />Signafure oF Applicanf <br />T. G�. [��"', t sT.t' i M <br />.St'�i' i"�'oisoN /�L'�, <br />Address <br />ielephone Number <br />Dalc <br />§ (y�� �l�.. <br />Fce <br />D T. A,�PPROVAiS � <br />,.�. <br />_ , ,; /�, ��,�y �'L <br />Engineers"� <br />Water --I,��, i .,�n.t� 9�/4—?` _ <br />Slreet <br />� i .,, � . . . . <br />Con::�:�.micctio:c___'_. .._—_. . ... _ <br />