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3 7�� <br />Permit No... .--_._.----_--.:.-=--- <br />APPLICATION FOR DRIVEWAY PERMIT <br />everett <br />CITY ENGINEERS ,--�.!'( r:r/'� y <br />EVERETT, WASH. c� <br />�-� Approved By <br />�v l�i= ' i�! �,�'U ���� <br />The Undersigned� n �O'U-'�T' GO • � j� �` ���` F= ��H � 1 SO^�� Daie Approved <br />Hereby applies for permission lo �� � F)ST �) I Z D/L!� — <br />At the followirg location R� Z y XA ��� 'r� � <br />The � dersigned owncn c�reby agrecs to hold and save hartrdr.ss ihe C:ly of <br />Everetl irom any and all claims for damoges Ihat may arise because of Ihc <br />installalion and maintenance of the improvemenl heret� applied for and <br />(urther agrees io remove same upon nolice irom Ihe City and lo replace ail <br />public property damaged Ihere6y. <br />Inspedor't Signalurc <br />� %%%: C=. i1/�wc Y' /% �-��j'%7i <br />Dale <br />Variance Required <br />Ycs.__ _. . .. <br />No <br />�' i �` ¢ � <br />�Z��4 cG �t>�st+,— <br />- SignaWre o( Applimnl <br />��`�� z — y-r�t_ <br />naa.e,: <br />31^s'. S ��. � 0 . <br />Tefephone Number <br />I,: ..�',t' /� - Z.- ''I <br />Dale <br />� pp � � <br />$ li� �3�<�9-C�--`--5� <br />Fee <br />CEPT. APPROVALS . <br />�. � �.�. .� �7,_ <br />..y..�G�-� � � � <br />Engineers � . <br />Walcr � i-,r;�i.r�.,�� _ /.�. _ . <br />Streel ..— --�_-_' _— - - - - <br />�;..nnr.�nicolions�:-'_f-.-----------' — <br />