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� � �'-�a i� <br />Perrmt No. ....._ - --- .............. <br />APPLICATI�N FOR DRIYEWAY <br />CITY ENGINEERS <br />ev�rett <br />'fifin,�-� c�.I����� <br />G Approved By <br />�/- / y- f�� <br />W � }� f `1 � i \ � _; `I Date Approved <br />The Undersigned ` - � -� °^- — <br />A Y <br />Hereby applies for permission to � � �� < T ' ` pY C� � S 7 '� �1 �^'� U �� �'� G'�_ �' ��� '� �' <br />At the following lomfion �� b � �� 3�� ��i L, v�' <br />SKETCH <br />IWork to be donel <br />The undersigned owner hereby agrees lo hcld and save harmlezz the City of <br />Evercll irom any and oll daims for dameges ihat may arise becau:e of Ihe <br />installation and maintenance of the imcrovement hereto applied for and <br />further agrees lo remove same upon ralice (rom the Ci1y and lo replace oll <br />public property damaged thcreby. <br />Inspecloi s Signalure <br />�rLi� !'.fi .%�i� % /c� - 7�/ <br />Dale <br />�rf%�- �= <br />Variance Required <br />Yes.__... _.__ ...._. <br />No......_...__ _.___.. <br />���� 5 �� �� �� � ����� <br />Address <br />�35's= 73 �/ �3 <br />ielephone Numbe� <br />S 1 ?. � E�re+G— �ei 4 ' —J <br />�- �i r � <br />