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,; — <br />7ermif No. -- :' _—'.. _.-_ _. <br />AI PLICATION FOl2 DRIVEWAY PERMIT <br />CITY ENGINEERS ��,� � ��,.� <br />EVERETT, WASH. Yt(lp�o�ed By <br />a <br />The Undersigned i/+'� �<^r!'jh�✓ L� �i%i� l�e ppwve�l d <br />Hereby applies for permi>sion to S�/iG7i"TD�' ;� Tir% r:r/✓ P�lJP�2 T f �L /iY� � <br />�rs- � <br />Ai Ihe following ocation <-� T/� �/L�l�/ A��b'S <br />_ h�i1 � ig w !/� � u/ ,J/z_ <br />SKETCH <br />IWork to be donel <br />� �� <br />4g�z8 <br />`N <br />Ex,� ro' <br />ow. <br />� <br />;� <br />Thc undcrsigned owicn c�reby ac�rces to hold ond savc harmlcss Ihc Cify ol <br />Evcretl irom any ard oll doims ior damages thaf may arisc becausc a( the <br />inslallation and mrinlenance of fhe improvemeN herMo applicd lor and <br />furtbcr agrces to r� mcve samc upon nclicr, irom Ihe City and lo rcplece all <br />puhlic propc�ty da oagr,d ihrreby. <br />Insp�dor's Signolwe <br />Dale <br />J <br />"C ,'! r� ro <br />'�''. /i=/'f! �,�,:_L <br />� <br />/ : sr> <br />� <br />va��a�« a������a <br />Ycs <br />No <br />Signalurc of Applicanf <br />Addresr <br />Telephone Number <br />Dalc <br />5 <br />F�� <br />UEPI�. APPROVALS <br />( a <br />Enginccrs,- �.` ��-ti�n. . <br />� �r.�_ <br />%Wafcr �p <br />$trr,M 11--'---�—" �✓ ___'_'_ �__� .t— ��.— <br />