Laserfiche WebLink
everett <br />APPLICATION FOR DRIVEWAY PERMIT <br />CITY ENGINEERS � y2:(l.t, /.� <br />EVERETT, WASH. �- ' Approved By <br />� � �iNf= ' � �!/ ".% -�: <br />TheUndersigned U � �FR���``��`hP L ILFTA <oi�sT. � DateApproved <br />Hereby applies for permission fo G O N�T %i 10 � Q�tw) <br />At the following loca:ion 3 30 �- M s DUcJ( /h L`- f� �E <br />SKETCH <br />IWork to be done) <br />I'�'lf.�� <br />1 <br />-_---- - ---- —I__. <br />M� C� CO �--� i�^ /a L L <br />The undersigned owncr hereby agrces to hold a�id savc harmless thc City o( <br />EvereN from any and all daims for damages thal inoy arise becausc of ihc <br />installation and maintenance of �he improvement heret.• applied for and <br />further ogrees to removc same upon nolitc from Ihe City and to replace all <br />public properly damaged thereby. <br />Li'iS��A�Y: ��_.. 4Ri.i_fAI� <br />(TdtY.': $CAi.€� <br />- ry ^.i� (�{. p,,,.c <br />� ; � <br />',�� t • <br />...`, "_� ."."_ �....TI 1�_'_ '•% <br />'� �� � <br />Inspeclor's Signafure <br />. Si� i���r'h-lJ G'5�9�7.� <br />Dafe <br />, <br />�:�/,77�C�G/i �l�i�"-�F'OG�i9L. � 2 2 _ <br />Vcriance Required <br />Yes <br />No <br />G� <br />a <br />AVE_ <br />(` �`'��`� � <br />��L 'l4dt t � � L.�`Ca.e_. � t,i�_e`Y.1 __•;''. <br />Signafure o/ Applicanf �) <br />� L7-Lp� ����� � � )[_�:J�.�f{ t � <br />Address <br />Jsi- �� 1 3�. <br />ielephone Number <br />3 � z ; �r7 �_ <br />Dale 7 � . <br />r o ys? -� <br />�-0 J � --�.�`cL - i %�-,,''Z__... <br />Fee <br />' 4; .,� <br />� `� ' � � ' DEPT. APP OV LS <br />_ �', /�-;����/} /�� <br />Enginecrr �'V� �! <br />_a -- <br />Walcr � <br />s«�i -- -- --- y--- <br />c,,, � , ,:..r.-, ------ --- - �- - - --- <br />