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EVERETT� WASH. ApprcveJ By <br />1�A2c� ��. ��T3 <br />\\(' I 4-� �' �- • � �. •'+'� '. - Dale Approved <br />The Undersigned ' ` <br />i � � ' <br />_., c=4 „�`. <br />Hereby applies for permission tc � ��>>Tt'. ;—i- ip '?o �S_o� CQ�-��_ � "� =•`1 � i> ' ' � � � � ! <br />r.a <br />At the following location � C� �L- ` �` � � � `� �� � 1 T <br />SKETCH <br />IWork to be d�nel <br />I <br />e <br />� <br />� <br />� <br />W <br />�/1�"..� �..'l.`.� �J11� <br />i <br />.-..,t-r ��l,tic._ nlw ,_ �%;,�J <br />?F� ����!c-,igned owner hereby agrees to hold and zave harmlezs the City of <br />Evereti (rum any and all daims for damages that may arise hecause of the <br />inslallation and moinlenance of Ihe improvemenl herelo applied for and <br />furlher agrees to remove same upun notice {rom Ihe City and to replace all <br />public property damaged thereby. <br />DRIVEWAY SECTION <br />NO SCALE <br />,�t. <br />:" C:�.l..�:.'`J � . <br />Inspedor's Signalure <br />s'/�� c/�EcKEp ��5-73 <br />u�re <br />—�-!__ �, -1 `5 <br />;di' /il <br />(`�,�� � <br />�,,, <br />� n �_� <br />Varionce Required <br />Yes_... _.. _ ................ <br />No.____...._........_... <br />��hd b'l.": s �r <br />/�.��: _, „��� j •-, r <br />�: :o-4�de i? ._e�1d'r-�.da,.y:: �:>�-:. ;. <br />Signafure o( Applicanf � <br />�,a � ,/ <br />�0 2 J��.-��.,�r.� --��-:= , <br />Address <br />� ��..i` � .,�' � � <br />ielephone um6or <br />�111�a, s' , ; r `7.-0.; _ <br />oaro <br />� E<�' o () y <br />Enginecrs <br />Water— <br />Streef — <br />Communi <br />Traffic _ <br />Planning <br />$ �� �z��- <br />�I�G Fee <br />� <br />3-�-J� <br />DEPT. <br />1 <br />�P<o.,�,. <br />