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v <br />Permit No. ../I�............... <br />everett <br />APPLICATION FOR DRIVEWAY PERMIT <br />CITY ENGINEERS _-;��;r� <br />EVERETT, WASH. Approved By <br />The Undersigned T ),-0 C, n1) T IZ-- F-= r-1 c - Date Approved <br />Hereby applies for permission to JSTA�_r G C �} p I rJ f—I ti <br />t✓ r- NI J= - n r� \ C I T �i PR eO -:�rCl f!/CAN J <br />At the following location — <br />SKETCH <br />(Work to be done) <br />IZ/.N t NI E-VZ-- <br />Av �. <br />�gKIsT <br />St of w At_ r= <br />R <br />�r <br />/62 <br />I <br />i <br />I <br />I <br />The undersigned owner hereby agrees to hold and save harmless the City of <br />Everett from any and all claims for damages that may arise because of the <br />installation and maintenance of the improvement hereto applied for and <br />further agrees to remove some upon notice from the City and to replace all <br />public property damaged thereby. <br />r <br />6/7/7 <br />Inspector's Signature <br />s iris L f1F_ 6:C CJ /�k <br />— �fe <br />Variance Required <br />Yes <br />No <br />r <br />I <br />! Signature of Applicant - <br />LJ <br />Address <br />77�,- 1) iF,g <br />Telephone Number <br />Dale <br />$ AID /= <br />Fee <br />Remarks Engineers <br />'/;7 Z <br />Water <br />-- Street <br />