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Permit No. ��--.__ _-��. L . <br />AP�LICATION FOR DRIVEWAY PERMIT <br />everett <br />�,L � �, . <br />CITY ENGINEERS %r��_i_ � <br />EVERETT, WASH. ' � Approved By <br />j� p� �j�' ^`�. � A ' �//l/I�n �, �Y /� <br />The Undersigned � �- � /'� �`� v � �'r `� J �.' "' Date Approved <br />, <br />Hereby applies for permission to_�1?�� %. � /�/ .!��� <br />At the following lomtion � � � / '- Q � �-- � d �1 � � v'F , <br />SKETCH <br />(Work to be <br />� <br />The undersigned owner hereby agrees to hold and savc harmless thc City o� <br />Everelt from any and all daims for damages thal may orise becauee ol thc <br />ins�allaiion and maintenance of thc improve�nent hcreto applicd (or and <br />further agrees to remove same upon notice {rom Ihe City and to replace all <br />public property damaged thereby. <br />rIS'� 1 <br />�] � <br />���� 2l!E � �- �'�7 } �-': � <br />Inspedor's Si nalure � �� ���� <br />_�iTic _.i�n�L�ic'�'"�.) C � -� ; <br />Dote <br />� <br />Variancc P,equircd <br />Ycs ... . ._. . . _. <br />No.. . .. ...__.. <br />� 1"�� ' �� <br />�/(, 7 � / ,w�--- <br />Sign y e ol Applicanf <br />1�� ������Y.� <br />Addrets <br />`5�3— ��q., <br />� <br />Telephone N mber <br />5 �S � <br />ale <br />��71�7L <br />�-�'�l4 <br />�� �� -; <br />$ ��1 `-- �7C�crP <br />-�. <br />Fee. <br />DEPT. APPROVAIS . <br />%'� �/ // , <br />Enginccrs . L���•-//'�'�` �/�' /�4- <br />Wafer 't:., _ -�- �. �. ,� �z- <br />Sir�et �-'-_ .—'—_—_- . <br />