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Permit No..--��...'...... everett <br />APPLICATION FOR DRIVEWAY PERMIT r'Le <br />CITY ENGINEERS C <br />EVERETT, WASH. Approved By <br />v <br />The Undersigned Dote Approved <br />�� �---�� <br />i <br />Hereby applies for permission to <br />,o <br />At the following location - <br />SKETCH <br />(Work to be done) <br />The undersigned owner hereby agrees 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 mainienan_e of the improvement hereto applied for and <br />further agrees to remove some upon notice from the City and to replace all <br />public property damaged thereby. <br />C' ? ✓V". yr <br />r <br />Inspector's Signature <br />Date <br />RECEIVE-' <br />APR 2 1970 <br />`gleter Supecininn9ent'4 Ur6CJ' <br />Variance Required <br />Yes _..__. <br />No <br />:s <br />R9 i_sC/ <br />Signature of Appl cant <br />r' IlAddress <br />1 <br />Telephone Number <br />Date <br />Fee <br />DEPT. APPROVALS <br />Engineer 121 f <br />Water <br />Street <br />