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_ / �_ _ <br />/ � <br />Permrt No. � 'J 1 <br />' �_.�.. ._ <br />APPLICATION FOR DRIVEWAY PERMIT <br />CITY ENGINEERS <br />EVERETf, WASH. <br />I ' ; j -� �? <br />The Undersigned �"�� � , '' " �" , <br />� <br />Hereby applies for permission <br />� <br />, i _ . �� •-,i„ � <br />everett <br />�'v-.:,�.,.:<a �,% i. c^-�.1..-- <br />:{,pproved By <br />�1irne 'z4 '�,4'i��'( _ <br />Date Approved <br />� <br />Atthefollowinglocation �.'� ; �,` �1 � , � _ �`- "���% ^� Evc=-'.--- /'/ <br />� � T. J <br />SKETCH <br />IWork to be donel <br />a <br />The undersigned owner hereby ogrecs to hold and sove harmlesz Ihe Cily of <br />EverMl from any and all doims (or domages fhof moy arise becouse o} Ihe <br />installalion and maiMenonce of the improvement herelo applied 1or and <br />furlher agrees lo remove same upon notice frem ihe City and to replace all <br />public properly damaged Ihereby. <br />% <br />.-' . / <br />. '�-..� -: .' _ .i ff.� A , � <br />Inspecfor's $ignalure ���� <br />r ir . <br />�r — <br />Dale' <br />Femor. s <br />�'- �j��> <br />Variance C,equired <br />Yas .. . . . . . .... <br />No <br />$ <br />�( . . /> <br />Signolure ol Applicanl� � <br />/ <br />/ ' <br />Add�ess <br />��/i <br />7elephone Number <br />Dafe <br />�rn <br />DLPC /.PPF.OVl�LS <br />i l� <br />Engineers � `� , ��=��� � � — <br />Water ` � �� , � <br />Slrecf �� �'''� r �`- �� <br />(':m.�......,.�iCr.. . . . _ ._. <br />