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� �% � I <br />Perrnit No�....��.l...�,.�...! <br />APPLICATION FOR DRIVEWAY PERMIT <br />everett <br />CITY ENGINEERS �?. ;, � v ����� <br />�.on�� <br />EVERETT, WASH. pproved ey <br />5��, '�.lo, I�t��i <br />The Undersigned � � �Jf�/lil��2 Daie Appro�ed <br />Hereby applies for permission <br />At the following <br />SKETGH <br />IWork to be donel <br />� <br />�' : c�o <br />. V. <br />22 I 23 <br />/o9.8s <br />L <br />24 <br />.. 7 <br />� <br />�— <br />r� �• <br />� / <br />j <br />. . ., i o,,,, �� ::J <br />,�in�,�E,�ron� ,� v� <br />The undersigned owner hereby agrces to hoid and savc harmless Ihc Cily of <br />Everetl from any and all claims for damages that may arise because o( the <br />installation and mainicnance of fhe improvement hereto applied (or and <br />further agrces to remove tame upon nolicc from the City ond to ieplace all <br />public properfy damaged thereby. <br />� <•„ _ ,:•r�._ _� �.�. _ . . . —i5 ;ITriC,.. ; +: . _� <br />� ,, . =-���.� e �. �� <br />� � G � / <br />.. ` . . ..�. /. <br />�—{ �� ��, . <br />_� � Y'G1-Yi"� ��=r�/-��/� <br />Inspecfor';�gnalure /J <br />� y/�-� <br />Dale � <br />Varionce Required <br />Yes_... .. _ _.. _ _ _........ <br />No. __._.. ..__.... <br />'�" �.rJ� ( `�'`p �'y: ,.✓. <br />�T �' Signafure o( Applicanf <br />r� <br />`' /z� isf�.��..� l.,� <br />A dress <br />353— 3iz_a <br />Telephone Number <br />DofC <br />� <br />Fee <br />DEPT. APPROVALS <br />_ > > �� <br />r <br />Enginccrs, ��'�V � � �'�^'�• <br />Woter <br />Slrect .t1�' , r d'dfa- �.. /L�� / <br />v24Y�L <br />i�vr.aiN <br />GE <br />