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'Permit No..._�.. ... <br />CITY ENGINEERS <br />EVERETT, WASH. <br />Tie Undersigned <br />APPLICATION FOR DRIVEWAY PERMIT <br />J, W. <br />everett <br />�,e <br />pproved <br />Dole Approved <br />Hereby applies for permission to Coca "f Tip t C % 20 r"T 4S"I i,12-e J— 91'P/611' '�*%4 Z <br />At the following <br />SKETCH <br />(Work to be done) <br />z <br />Q <br />J <br />i� <br />21z�L S2�Jo <br />Tf.e undersigned owner hereby agrees to hold and save hnrmless the City of <br />Eve.ett fren; any and all claims for damages that may arise because of the <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 />DRIVEWAY SECTION <br />NO SCALD: <br />- zv r --- <br />j l- LIP <br />J <br />30" — 30" <br />Inspector's Signature ' <br />Date <br />Dr2 i vE WAY <br />D FZI V E WAY <br />�,CAt_E) <br />Variance Required <br />Yes_......................... <br />No_........................ <br />Signature of Applictint <br />Address <br />Telephone Number , <br />Date <br />$�a�=-�-7z <br />Fee <br />�cJp pMt3. <br />Engineers _ <br />Water L <br />Sired <br />J/ <br />