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Permit No. <br />APPLICATION FOR DRIVEWAY PERMIT <br />CITY ENGINEERS <br />EVERETT, WASH. <br />The Undersigned M c VI r4 A M 1 t T,J N <br />Hereby applies for permission to o NST. j� o.dCT ETE �J� 11/ <br />Nn <br />At the following location / 90O — 5� — —L <br />\ IyETC <br />ork to ((die oTe ' <br />denet—" <br />'rhe undersigned owner hereby agrees to hold and save harmless the City of <br />Everett from any and all claims for damages that may arise because of fire <br />installation and maintenance of the improvement hereto applied for and <br />further agrees to remove some upon notice from the City and to replace all <br />public property damaged thereby. <br />IVEWAY. -- SLCTIAN <br />(Wi+-:."SCALE) <br />y M <br />9c- <br />'''` Ai'LiP <br />Inspector's Signature <br />Date <br />i /- <br />evarett <br />,e., <br />Approved By <br />Dcte Approved <br />S7-0,T y <br />Variance Required <br />j Yes ... <br />No _.. <br />Signature of Applicant <br />Address <br />Telephone Number <br />Date <br />Fee <br />DEPT. APPROVALS <br />Engine <br />Water7-- <br />StreeI <br />