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� <br />Permit No.._ ..........:..:....:.:.:... <br />APPLICATION �OR D�IVEWAY PERMIT <br />CITY ENGINEERS <br />EVERETT, WASF'. <br />everett <br />Approved By <br />The Undersigned � I+ Daie Approved <br />Hereby applies for permission to � �� � � " " ��q� �� ' "�` �' � - ` ''`� � " l-'' ' ���'' <br />At the following location "' :. � �' - - ; , ! / .' : f.' +- . <br />SKETCH <br />� Nork to be donel <br />; <br />/ <br />; <br />7 A/e l • �;� <br />J �a� c <br />_" R9 <br />3{�O �s <br />/ ,_{Q �"v�.... <br />, <br />The undersigned owne�� hcreby egrecs !o hold and savc <br />EvereU from any and all daim: for damages ihat may <br />imfa!lalion and maimenancc oi the improvemenl her <br />furlher ugrees lo removc sam_ upon notice from Ihe C� <br />�ublic property damaged thcicby. j <br />Inspectoi s Signafurn <br />Date <br />� <br />�rmless ihe Ciry of <br />ise because of Ihc � <br />applicd �or and <br />and lo replac�ll <br />� � <br />/ <br />�� � <br />, /_ _ <br />, ;. <br />ti� <br />Q <br />i ��, <br />44;.�:y <br />c <br />`✓ariance Required <br />Ycs. . . _... _... <br />No..._..._ .... <br />� ' i �_ <br />�,r''^L.l��� i�%/,�, � <br />Signofure `�i(. D�I canl <br />�vU l2 %2�r.'�r3�C��c �` <br />ndd.�t� <br />�� 3—-�i1.; <br />7elephone Number <br />�rz z � 7/ <br />�ar� <br />5 <br />Fce <br />DEPT. APPROVAlS <br />Engineer �� - , <br />Water �i rT �-c�-.. /• t i �7l <br />Slreet � <br />Cammon�cr.tions— <br />