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}yGC�(��J'�tO <br />/ <br />_'_� U. Cf�,�-L�;, <br />��1�-, <br />� <br />:.,=��� , <br />Ci iv �-nnim=_er <br />tveretl� �.�shinr�lon <br />�,PHa�n c coric�Er� ��iv_;�;nv <br />�vereti� P:shinaton <br />�.-rch 1'�� I�C,S <br />Permissi4r is requested to pav,� {he driveway area indic�ted on sl�eich <br />with Asph�:tic concrete. V4ork to be done under the supervision of the <br />En�ineerinp Deo�rtment. <br />The undersigned ov�ner hereEy agrees to hold and srve harmless the <br />City d'tverett from any and all cl�ims f�r damages that may arise <br />Fec�.use of the insiallation and mainten�nce of the improvement h�erefe <br />=ep'�.ied fcr �nd fur{her anr�es to rernove eame upon notice f'rom the <br />C'i lv and io renlace al1 o��tl:c proptrly damaQed tr�eroby. <br />Ycurs {ruly <br />�� ��. �/ , -�, . <br />r,� ��vJ✓ (�LG�..-C,_i(,' L���,7�".��G�f:'%� <br />�� �� [� � � <br />q •�f % , ! <br />- - '�!i •i,_�/��fl�i _j=/ �/�f/_j'� <br />