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Fer nit No. _: �_ _......:,:..___ ..._ <br />CiTY ENGINEERS <br />EVERETT, WP,SH. <br />The Unde�signed <br />Hereby applies for permission <br />At the following locr.,tion_ <br />SKETCH <br />IWork to be donel <br />� �, F� ' ' <br />APPLICATION FOR DRIVEWAY PERMIT <br />�„ . . ,_ -/�.; <br />-��= �1 <br />, ,z• � <br />The undcrsigned owncn c�reby agrees �o hold and savc hormless the City of <br />Evcrett from any ond all doims ior damoges thal may arise becouse of the <br />insta�laiion and moiNenonce oF the improvemenf hereta opplied (or and <br />furiher agreos b ramove some upon notice from ihe Cily ond b repbce oll <br />public property damaged ihereby. <br />1Y.5w,1Y: �::-5ECt10N <br />(i�7v �. � SCrtt� ) <br />.`� `�--_--=�'� � p - . a" <br />( �'� --�.--i5 <br />, t__.,.. <br />Inspecior's Signalure <br />/ <br />���r� �.yfc�� �) ; �.zi'7i <br />Dote <br />\ <br />everett <br />�-��s�%� <br />-- Approved By <br />�P.QiL /,c �_/D7, <br />Date Approved <br />, ' <br />.�3 � �4 <br />J l� .� • S <br />.pS15/61ZAY_ _ SiCTtO W-.-' - <br />1� „ � <br />�� L. ' -- .. _�:_ _ _— ae � <br />.V .; . _ \VA <br />- <br />Variancc Requ�red <br />Yes . .._____._._. <br />No..... ___ ........ <br />- ��� $iy�afurP o( Applicasf ��— <br />' . ,� <br />Address <br />7elephone Number <br />Dale �, " <br />�, �. y�7 <br />5 L.� ��/� /� <br />Fec <br />DEPT, _APPROVALS <br />1.='� '/ / /// , <br />fnqinccrs'.'._�J''Y�I.��/C�.�l' f'�,�:'^�"%/ <br />, . . , ,- ... � <br />„ <br />;.' A'-ib�r'_.___.._._-_.:_ ___.—_.__T_—_. <br />