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ti <br />Permit <br />APPLICATION FOR DRIVEWAY PERMIT <br />0 <br />CITY ENGINEERS <br />EVERETT, WASH. <br />The Undersigned — <br />Hereby applies for permission to <br />At the following <br />everett <br />�e� <br />yfkpproved By <br />{�uc�us�" r,Lri la(o�L <br />Date Approved <br />The undersigned owner hereby agrees to hold and save harmless the City of Variance Required <br />Everett from any and all claims for damages that may arise because of the Yes <br />installation and maintenance of the improvement hereto applied for and No_.._._._.._._.��. <br />further agrees to remove some upon notice from the City and to replace all _ <br />public property damaged thereby. <br />CIO <br />nspecfoi s S <br />r5�nature ti-.ae <br />=e/y <br />D, <br />6afe <br />Signature of Applicant <br />Address <br />Telephone Number <br />Date <br />Fee <br />Remarks <br />DEPT. APPROVALS <br />Engineers <br />Water. <br />• <br />