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,, .r <br />Permit No. _._....._._. <br />APPLICATION FOR DRIVEWAY PERMIT <br />everett <br />CITY fNGINEERS ,��� '�,� <br />EVERETT, WASH. — � Approved ey <br />� y /O, �97/ <br />� �� �,,- <br />The Undersigned `` i-1 l� A P h' � �ai� Appro�ed <br />Hereby applies for permission lo ` ''` <br />At fhe following location � � <br />SKETCH <br />IWork to be donel <br />_,- _ z- `�. <br />--- --- ---- - <br />_ _ ,�_.� _ <br />�. , r <br />Thc undcrsigned owncn c�reby ogrecs fo hold and savc harmless Ihe C�ty of <br />Everell from any and all cloims for damages th�l may arise because ol the <br />installc�ion and maintenance o( Ihe improvemenl herelo applicd ior and <br />iurther ogrees �a remove same upon notice irom Ihe Cily and la reploce all <br />publi: property damaged Ihcreby. <br />DFi�•�E��,+.Y. _ 5[CTIpN <br />(v; o _ scnt: ) <br />�: �� <br />�i � <br />���) ~�..�.�..'.._ '� <br />. �' —_ _ _ �VE <br />u �I <br />Inspecfor's Signature <br />i <br />� �T".E � h/FG:c�Fi `� c�/% <br />Dale <br />� <br />/��.�i) ��– /.cJ_1-'Lr_��� i �i��`�cJ �'i �� ,�%=�� ,c <br />�� . <br />� <br />�j� <br />Variance Required <br />Ycz .... ._._. ...__. <br />No.._ . . . _. _... <br />� <br />� fT %,' ;? v r�. l C�: � f� <br />Signolure ol Applicnnl <br />Address <br />�"J / � / ,� >C /�- <br />Telephane Number <br />✓ _. � .. �� <br />Dafe <br />(• n � <br />5 � — :. .✓i ' -r , <br />Fce <br />DcE,�P/T. APPROVALS <br />Enginecrs i� � ������'��'`�J//� <br />� <br />Water � i `-•_` .I ' %- �7 / <br />; —� <br />strc�r <br />, ... .��n.__ � __' __.. __.. <br />�- <br />