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Permit No. _.--- _.------ <br />CITY ENGINEERS <br />EVERETT, WASH. <br />The Undersigned�� •� �' <br />Hereby applies for permission <br />At the following lomtion �r/ <br />SKETCF' <br />IWork <br />r� <br />;7_ <br />APPLI�,4TION FOR DRIVEWAY PERMIi' <br />� <br />�, �3 l _-��' � ._. �._ <br />e�verett <br />, I <br />v�bD �'.�-� <br />—�pproved By <br />�ecemher 17 1qi��t <br />Date Appraved <br />The undcrsigned ownen c�reby ogrecs to hold and savc hormless ihe City o( <br />Everett from anv and all doims for damages thot may orisc because of thc <br />insla!latian ond mointenonce o( the improvement hereto applied for and <br />iurlher agrees fo reriove some upon notice (rom the Cily and ro replc<c oll <br />pubGc property damoged thereby. <br />i <br />('�.'.� y'.-�� z/1/r/.D <br />i <br />�����. <br />i � <br />��.--- ,ti .,. � '-� <br />/y. - � j`,�,. . r ���;-� <br />Inspecror's Signafure <br />DaM � <br />Rcr,t�r�s <br />�`. <br /><; : <br />;,. � <br />nry <br />Varioncc Required <br />Yes .... ... . . . . ..... <br />No <br />� <br />� <br />�_ � . , <br />\ {' _,J � ; '-. ' L . <br />L.i <br />t �:.Signnfure of Applimnf /�./`_. <br />' i1 7j <br />� Address' <br />' ', <br />,� � ielephoce Number <br />Dale <br />$ <br />Fce <br />UEPL APPROVALS <br />�, i <br />i <br />r rY . � <br />