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Pe,mit No. <br />APPLICATION FOR DRIVEWAY PERN'T <br />CITY ENGINEERS <br />EVERETT, WASH. <br />The UndersignedZ/QUW`5gJ�Y <br />Hereby applies for permission to <br />At the following location <br />SKETCFI <br />(Wo-k to be done) <br />►-w xw <br />"loved By <br />'3: iqf.Dq <br />Date Approved <br />K/V 5 T- Vi E W DR,/ VZ I <br />AY <br />E VE,QGRE�N CEM. <br />The undersigned owner hereby agrees to hold and save harmless the City of <br />Everett from any and all claims for dcmages that may arise because of the <br />installation and m-sintenam,! of the improvement hereto applied for and <br />further agrees to remove same upon notice from the City and to replace all <br />public property damaged thereby. <br />i <br />Inspector's Sig 290re i— - <br />'71 9 <br />Dole <br />NOTE <br />C!'-CK P'ITN VrATFR <br />Df T. LINE <br />L C '.i:.5 U.,,, E EXCAVATION <br />�ROi' '�. � c.R..`.GE <br />Variance Required <br />Yes _....... <br />No_.. _.. _._...___.. <br />i <br />Sig6alure of Applicant <br />Address <br />Telephone Number <br />Date w, / <br />G <br />Fee <br />DEPT. APPRO'rALS <br />Engineers � <br />Water <br />_ Street - <br />