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Permit NO...SLZ..r-•......... <br />-- <br />APPLICATION FOR DRIVEWAY PERMIT <br />CITY ENGINEERS <br />EVERETT, WASH. <br />everett <br />,e <br />Approved By <br />7— 6 _ Z/i <br />:y <br />The Undersigned IOh r✓ L OYtttYtl '' f-Itin 004 )hike ✓bran h Oaa!'h Date Approved <br />Hereby applies for permission to C n u1 n Cs- u c iCl G 3 —Fi— t4 V r u a uA r] U <br />At the following hcation---11f � a' <br />SKETCH _ ( t \T „ ) - - <br />(Work to be done) I = Vo <br />L <br />rr , <br />21' <br />IORE AVE. <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 maintenance 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 />Y <br />'kVjl, (ten _ scwcs ) <br />Inspector's Signature <br />Date <br />Variance Required <br />Yes........ <br />No......._- <br />�7 <br />Signature of Applicant <br />�7 <br />!� Address <br />Telephone Number <br />Date y� <br />i <br />Fee <br />Water <br />Street. <br />KA <br />