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Pernit No. .. .(...�..�...�. � I <br />APPLICATION FOR DRIVEWAY PERMIT <br />everett <br />/ <br />CITY ENGINEERS <br />«, �� `;'. ,.,�: <br />EVERETT, WASH. Approved ey <br />/i �%'i�r?F� � ��/� <br />The Undersigned <br />�'J� �--Lf F�• i' C'7 I A�fL-o (� Dalc Approved' <br />Hereby applies for permission to � ^� � '7�- ` � � s `�'� � �� r � }` � � JE- � � � � � <br />AF the following location I g ZS � v t�n �` � T �-'c� %� <br />SKETCH <br />IWork to be donel <br />L., i� i. nV .� . �.. .ai <br />qNO GUTTER <br />- ,r-ti�trr <br />The undersigned owner hereby agrces lo hold ond sovc hormless Ihe City o( <br />Everetl Irom any and all claims far damages Ihat may arise because of Ihe <br />inslallation and mainlenoncc of the improvement hcrelo opplied (or and <br />(urlher ogree� to remove same upon notice Irom Ihe Cily and to reploce all <br />public properly domaged thereby. <br />DRIVEWAY SECTION <br />NO SCALE� <br />�.--- �S <br />I� LIP <br />� p� � _�30�� <br />�1��,�c �= � � �=,�? t�Y ,��r�. <br />Inepedor's Signalure j-� y� li � �=(%,(J � F� J <br />� r� <br />�' � �. -'�>�^��'-.i= � �'%����_= -- <br />Dale <br />r�� 1 � = <br />l /9 i�L O l=- <br />/� � <br />r ��-' <br />�� � <br />�� � - . � - <br />Variancc Required <br />Ycs ._ . ._ _ ..__. <br />No... . _.. . . <br />Tfl Y�- ��'�° <br />� � t � /' <br />� � ' L' �,: �c2�., f,� . t,.,,G`F,_�(%' _ <br />$ignalure of Applicant �_� <br />„ <br />� a7 � < �.��� -- ,,•; .:�„ <br />� Addrezs µ <br />� l �r�r � <br />Telephone Number <br />Dale <br />, ,. +=�, i i� <br />a - , : ,- <br />� i Fee <br />��:; -� c> <br />l�_,� �.�.- <br />DEPT..APPROVALS <br />Engineers � r "-`{'�� = � � ' — <br />Waler � <br />� i �/. � �- •. L .!� <br />S�fCC� <br />Co�^u^_'nimlior:s " -�----- <br />