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. �3-�� <br />Permd No........- ....................... <br />CITY ENGINEERS <br />EVeRETT, WASH. <br />The Undersig <br />Hereby applies for permission <br />APPLICATION FOR DRIVEWAY PERMlT <br />_ i. <br />� �� . / ) ') _ C , � _ �_ <br />/�.,� c c r/' ��n T A 7! �.S%��//'7r� % <br />... �_„ -- �--.:__ s��� s��-,�� y� �A���- <br />everett <br />,. <br />� Approved By � <br />,� - ,_ <br />Date Approved <br />c.-�.�� ����- <br />The under.igned ownen c�reby agreez lo hold ond savc hormless Ihe City of <br />Fverell irom any ond all claims for damages Ihot may arise 6ecausc af Ihe <br />instollation and maintenance of the improvemenl hcrelo applied for and <br />further agrees b remove same upon nolice from the City and lo replace all <br />public praperly damaged Ihereby. <br />DRIVEWAY SECTION <br />NO SCA�E� <br />�--- Z � <br />I" LIP <br />�30-�--f� 30�� <br />;.-A/ i=' <br />;?,, ' � <br />Inspeclor's Signafure <br />' ' '7s <br />�. -�i—� ' �'l� . � <br />� �� � � � �'t-:���� � ��� <br />Dalc � <br />Variancc ficquired <br />Yes. _ _ _ .... .. . . _... <br />No <br />'_ �...C�.�:../ ' :�� � . <br />: � i^ Signalwe o( Applimnf . <br />� _, <br />�, : -- � , . . <br />Watcr: <br />Slreet �_ <br />Cenim�ir <br />Address <br />- "'.=�:-i <br />ielephone Number <br />Dalc ��;7 <br />� <br />'a /!� <br />S ',',' ' , � —z��-�_� <br />� �-- = . <br />Fee <br />�� . � <br />DEPT. APPROVALS <br />� �� <br />. •�( - � i - 9_% <br />._ .: . . ... � _ <br />