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� ^ - <br />� <br />Fermit No..>..- ��:....-5:.1._ <br />APPLICATIQN FOR DRIVEWAY PERMIT <br />everett <br />CITY ENGINEERS ����.�,� _ <br />EVERETT, WASH. Approved ey <br />/ /t'l/� y ,� �i ����, <br />�7���� %i li �I D��.�`— � Datc Approved <br />The Undersigned - _� <br />r��2e��� 1 �_.` . �j� ' �,.� . <br />Hereby applies for permission to � � �%�'�-� �"' `''� �� �f-�� �r ! r�,:" ' �' <br />J t� � ,,,7 �if � / �7'J� 9i-�Ci•v � � /i % , i � � i �,. .� � <br />f r! /.I ;l ' % �!. . <br />� / // � <br />At the following location JY �� ����S�T L':�.Q �' � — <br />SKETCH <br />IWork to be donel <br />a <br />U b ��U✓/✓�-1'}'�1/Gf� RFTA�� <br />cc�;:::- _ . _ <br />LOT <br />20 <br /><;1 <br />The undersigned oH�nc� hereby ac�rees lo hold and savr harmless Ihe Cily of <br />Evcrctt from any and all doims for damages that moy aris� because of Ihc <br />installation and maintenancc of the improvement hcrclo applicd for ond <br />(urthcr agrces �o remove samc upon noti�e (rom ihe Cily ond lo replo<c all <br />public properfy damoged Ij�creby. <br />.f�� . '..�� �.� i <br />;� <br />i <br />� ' ��F�7 � =�•)(l�dJ :�L�.l' <br />.i � ` '" <br />�1 � i <br />� � . <br />, � `-�' °��- <br />Inspeclor's Signolure <br />.S�r� C/�Ecn;�rJ `'���7n <br />Dale <br />ic' <br />� <br />f',�: � . -'_� � ���: ; :.,=:> '� 1,-: r'. <br />Variance Required <br />Ycs <br />No <br />�. i ' <br />� �i ��l ,"' �,�' ._'- _ � '�rll���Y <br />Signolurc o( AppLcan ' <br />� ,. . <br />C�''�' r.'- : r. - <br />Address <br />\.- : / �' , � <br />7efephone Number <br />�,° i! �i / S � . �' .=� `..' �: <br />' Do1e <br />$ � <br />Fee <br />DEPT. APPROVALS <br />Engineers -"'"�`/''��- G�'/'�/tiC' {/ � , <br />Watcr i P�� ' �' �%�i�*.' + _ <br />Strect <br />7�: �,- <br />+� �,. . �.. . _ .-�_, . _ _ _ _ __ . _._ <br />