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I/[ l <br />Permit No. ,� _ '..___ <br />CITY ENGINFERS <br />EVERET(, WASH. <br />The Undersigned <br />r_ - <br />APPLICATIOt�I FOR �RIVEWAY PERMlT <br />everett <br />'� ;,,,.,�. �. ��,t_�.�� _ <br />v Approved By C <br />/� - � - <br />�� <br />Date Approved <br />__ ' <br />He« tby applies for permission to �! -, i._ �:�= � A. 5 GRA1l�L �D � 1-'�,, yJ�-1 �� �'�( S T, <br />---�7� �.1 � )-�1„I�— — -- <br />At the fo'lowing bca�ion v �� �� � � `-rY=��� _�� �;.1 ��::`i` ^ <br />SKE:TCH <br />(Work to be donel <br />-_— -,:—.. :� . ... __ -_..., <br />.�-- - - ------- - - - -�.�s.�:.:.,,_�-_:;. <br />�..I � �_-.-_.r�..�. : <br />�or �5 <br />I �OO� i <br />_'��— <br />I <br />�-z'�" -r° rsr r�'a :, <br />IJEL'� fx�sr, ��w <br />ADN1'� on1 <br />�__ �—_ <br />_ . __._. � r�.C-X1.57: sTFct-.t; I � :'�cF.li,l <br />f-- ' ' - -�- - --f <br />- - - - � - - ` - -- � — -"--_ - . <br />— -- — - ----- I1, , <br />— — — —W�S-f— —VI�-W D�, <br />The undersigned owner hereby agrecs lo hold and save harmless Ihe Cily n( <br />Evcrett from any and olI daims fcr domages that �.nay arisc bemuse o( '�c <br />installolion and maiNenance of Ihc improvemenl hcrel. applied for �nd <br />furiher agrees �o remove some upon no�ice Irom the Cily and lo re�' .c all <br />public prnperly don.aged fhcreby. <br />DRIVEWAY SECTION <br />NO SC4L� <br />— .S <br />+I" LIP � <br />r30 I. --- 30,� <br />� �� � �; �[, <br />, <br />�— - -- -µ-C�� <br />Irsporlo/s Signolurc � <br />' tr_ ,' _'- � '�-73 <br />Dorc <br />` }--� -- <br />Variancc Required <br />Yes <br />No <br />�,�r;"�., � r�...� '� <br />� <br />° ! lJ , <br />i �� <br />i — _ _ <br />� . S��nalure.o( Appl�'mn� . <br />r-� � � � <br />z! � � / ,�-� ; f ,,• _ <br />Address <br />>�—,� _l-? � �� <br />Telephone Numbcr <br />i <br />� �L�o1.5 i � -� <br />Dafe <br />T _ /, � �� j r <br />s r, <br />1 � <br />��. � �U �'"� G�'�C/ Fec <br />��J - �-=' <br />���� DC� X�I � CoNCRETE �LF1C3 PDURt=D fN RILI� <br />Remorks <br />1l_':t�lt. � . l��L. ���ti� �, -� .. _.- <br />DEP� APPFOVALS <br />� <br />� �, �, 4, _ <br />Enginecrs _ � <br />�: �. � � . �,- ' - <br />Woler --- ------''" `,,.�.. , <br />Streer <br />Commun�cations �___.___�...___" _ <br />