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<br /> Permit No. .�. _rr'' �-- �
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<br /> APPLICATION FOR DRIVEWAY PERMIT
<br /> CITY ENGINEERS % �
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<br /> EVERETT, WASH. ' t , ' Approved ey
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<br /> The Undersigned �/� �'� ��� ���! )'` ''-� '-1! / Da�e Approved
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<br /> Hereby applies for permission to �—�N�7r � � Z S tJ✓ � (>> � S (�f� .� �G I I�C' l��fJ-�--f_
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<br /> At the following Incation � �a � � " 4'� "— `-�y�-
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<br /> SKETCH ' ~ �
<br /> (Work to be donel ' J 2
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<br /> —��""�� � {�EMOVE EX13'�" GVAR.D 'RA� L
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<br /> Thc undersigncd owner hereby agrees lo '��Id and save harmless the City of Variance Required
<br /> Everelt from any and all claims for damages Ihat may arise because of ihe Yes � �
<br /> ..._._.._.. ._ _ ___.
<br /> installotion o•�d maintenance of fhe improvement herelo applied for and No.._. _....
<br /> (urther cyrees to remove same upon notice from Ihe Cily and lo replace oll � �� �-����-�--
<br /> public �i.perty damaged thereby.
<br /> i DRIVEWAY SECTION ' -
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<br /> NG SCALE " , �
<br /> II �w__ ,�,.r I � � Signafure oF Applicanf.�,y -� .
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<br /> Address
<br /> 30" 30" �i-�/�. .: � ,-i �:,.:ss! c��io�J.
<br /> 337-�3. ; 0--� 2,-a _ � :� :
<br />� Telep on'e��mber �"�' �
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<br /> Dafe
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<br /> Inspecfor's Signolure �" t S I ? -� ��:�i:�-
<br /> K�G'C�L� ��.�� ri-<<.0 Fee
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<br /> DEPi. APPROVALS
<br /> Remarks Engineers ��
<br />� Water �: , �,.. '; .t��i_,.
<br /> i ._ Slreet�%��... l�•�� ,.(�..:�.� �
<br /> Communicelions ��+ �� �
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