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Permit No..�..�...�..�(.... <br />APPLICATIO�� FOR DRIVEWAY PERMIT <br />CfTY ENGINEERS <br />EVERETT, WASH. <br />everett <br />--�� ����. <br />- Approved By <br />/� !-�. c' .��' lU�'� <br />The Undersigned � � N�� �.' Q�h=F� Daie Approvcd <br />Hereby applies for permission to CnAL T/' `' �,� ! A) l RI K �'� I 1!' 8 �►J =�` -T � �R-'J r=s`'� <br />/ _ _ �� .t ,\ <br />At the following location 2 Z�� Z- -�UMM\T � �/f <br />SKETCH <br />IWork to be donel <br />�UMM�T <br />AV � <br />� <br />� <br />� <br />Thc undcrsigned owncr herc6y ogrees to hoid end sove hormless 1hc Cily of Variance Required <br />Evcrett from ony ond oll claims ior damages Ihat may arisc hemuse of Ihc Ycs <br />inslallotion and maiNenancc of thc impmvemcnl hereto applicd for ond Na <br />(urther agrees fo remove same upon notice irom ihe City and lo replace all <br />public properly damaged Ihereby. <br />� �' <br />� <br />�J�,I�L�f � �IL� �' ��" I [ /s ;-. <br />Inspecl r's Signolure <br />. <br />'i : , <br />: `�/%�� L /�C< .t�i='; ? �..i �7� <br />Dale <br />Remarks <br />}- . <br />�'/"�')� .'i::.oL, �`�'i./.i'. /���U <br />. ,. . ' $ignofure ol Applic'6nf � <br />:'�/1 � /� � 7— <br />� ,C�� _� L<'i,J'/,�,c.t� <br />Address <br />l' �-_=-�,�- �`/�.' � <br />Telephone Number <br />�_—r� ` .�'7�•, i; �-.j';. <br />� � l( �. � Z.�_ i� : ?. [. � • / <br />Dale <br />b N 2, �c � <br />� / <br />' �C v /..� �"'_` Fec <br />/ ��ZO- ��`/ <br />DEPT. APPROVALS <br />' / i � ,: � <br />i 7h . � ;' <br />Fngincers"�" - ��.�� zf- ". ,�- , �_ <br />Wotcr.�_i-�-"_�- .i' i� Lc� _ <br />Strect - - � � � - - <br />Coinr,:��;ni�nlions___. _ . _ . _ .. <br />