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Permit No..Z------•--• <br />APPLICATION FOR DRIVEWAY PERMIT <br />c-: <br />CITY ENGINEERS �^ 'N�Rp� PARK <br />EVERETT WASH <br />everett <br />�e.� <br />The Undersigned- _ \nl H L L U 1 S Tn P H E R 2 O P� Dole Approved <br />Hereby applies for permission to P A 1 5C r P-A ) r- 6 F A I-L E `/ F O2 13 � <br />At the following location iI --3 Z 7 P I I C K F R As/6- <br />SKETCH <br />(Work to be doi <br />W <br />X <br />v <br />qo <br />Tu 0rrsr iw►: �:arr�ere�:�.1.� - <br />44-T H <br />The undersigned owner hereby agree! to hold and save harmless the City of <br />Everett from any and all claims for damages that may arise because of the <br />installation and maintenance of the improvement hereto applied for and 35f'fi <br />further agrees to remove some upon notice from the City and fo replace all l <br />public property damaged thereby. <br />.. �C y'c� Lfl2vrz <br />,���)7r..lsC l=U � _ v/A �c'LT �.J S7N Lcv1 TrD r� <br />>c^ <br />PROVIDE FOR <br />PROPER DRAINAGE <br />Inspector's Signature <br />NOTE <br />Dore (HECK WITH WATER <br />"'-'PT. FOR WATER LINE <br />L• i:'''i `'s RETORE EXCAVATION <br />5T <br />Variance Required <br />Yes. __. ..... <br />No....... <br />Signature of Applicant <br />A�ress �� <br />Telephone Number <br />Date <br />FEE <br />Fee <br />DEPT. APPROV IS <br />Engineers <br />Water <br />Street �;..• - <br />