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--� ;�_ � <br />Permif No. ._ l_G.., ...... �--:'-- <br />APPLICATION FOR DRIVEWA,Y PERMIT <br />CITY ENGINEERS <br />EVERETT, 'JVASH. <br />everett <br />%�� �� f <br />a <br />__ --%C—Cii� <br />Approved By <br />F�gRUAR �( C3�� ��%�i <br />��L O� � Dale Apprcved <br />The Undersigned��. � <br />Hereby applics for permissian ta1-�% �ST• A z� .i��G(� <br />At ihe following ��cation ��' �— �(.l� � L%1�=� R�— U L�� <br />SKETCH <br />fWork to be done) <br />n <br />� <br />UKI �.'�� G 13LVD. <br />8' /� .C. <br />Tlie undersigned ownen c�reby agrecs to hold and sovc harmless the City of <br />Evereft }rom any and all claims for damages that moy arise because of Ihe <br />installation ar.d maintenance of thc improvemenl hereto applied for and <br />furlher agrees lo remove same upan notice irom the City and to replace all <br />public properly damaged Ihereby. <br />Ne'�; /0�°is r��� oN PE2n�r'�3b97 <br />gGrFo�zE i}�ts PCK7/T is fs>�s�, <br />%J�� � <br />tl %,�i,iY�. � �17 . <br />�/ <br />i; '� <br />L <br />InspeUor's Signalure <br />_5�/T.4' �c,'C-r^..��� 2�h` ��::_ <br />Dafe <br />Remarks <br />�L_ _ <br />� �: <br />� <br />�� <br />, y:j ; , <br />..' �� ._. ... <br />� <br />� <br />0 <br />N4 SCHI.F <br />Variancc Required <br />Ycs.__..____._.___... <br />No...... .. ._. _.._.. <br />i. ,� � <br />,, ,: <br />Signalme or Applicanf <br />- / �: <br />Address <br />� - i <br />°i ;` _ i -'_ . ; <br />� Telephone Number <br />�` zL� %�— <br />Dale <br />S %O � � < «��� <br />/ <br />Fee <br />DEPT. APPROV,AL <br />.��'/f` �� �� <br />Engineers "" ��y � <br />� _� <br />Waler d.-;:`-� ' ' - � � <br />�— .. <br />Strect — —"'� <br />(�.�. '�.ica!iun;__�._ - . . <br />