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P2ftllif n6. _-.��:.:r .............._._�; <br />CITY ENGINEERS <br />E\�ERETT, WASh!. <br />c =' <br />1'he Undersigned '=�G'� <br />Hcreby applies for pennission Yo. <br />At fhe following location y <br />.— — �._.__ <br />SKETCH <br />IWork to be donel <br />PROVIDF FOF <br />p�-igt'fR DI�AINAGE <br />APPLICATlON FQR DRIVEWAY PERMIT <br />- � <br />�v��, „ �(:i. <br />� <br />''t`i� i •���•'�i�: � , <br />, <br />/� <br />''t�`/�.r- <br />CHECK VJiTH '"fTER <br />pK; -i. FO'i WATER LIP:ErAVr:TIOf� <br />� <br />The undersigned owncr hereby agrces to hold and snvc harmlr,s Ihe City of <br />Everell from any and all claims for damages Ihaf niay arise 6ecause of Ihe <br />inslalla�ion and moimennnce o! the improvement herelo applicd (or and <br />(urther agrees to remove same upon notice from the City end b replace all <br />public property damaged Ihereby. <br />;�i <br />� -- . ... �� , ` - <br />-� <br />' � �A. ..p-`/ i_. �--Ltil,�> <br />Inspecfoi s S±gnalure .� <br />. �` <br />. <br />� � <br />Dafc <br />� <br />� <br />everett <br />i � ` ,<..-.. <br />� <br />.0 pproved By <br />1)S �tr�� \�'(�Q <br />Dote Approved <br />0 <br />Variance Required <br />Yes. _ ._.... _. . .._.... <br />No. __....._._....... <br />�..� � , ; ,_l 1,�,C - <br />� � , <br />�� <br />����� �� t �_i� �..�.t � � <br />�,� �:' ' <br />� $igdolure ol Applicanf <br />` If' <br />�.(.��_ %�.�.4�u ;)� .� . <br />Address ' ,. <br />i <br />� � i..- '!'ial. <br />Telephone Number <br />Dafe <br />� l � -/f-7/,;. . <br />Fee <br />DEPT. APPROVALS <br />1 � �1 f � ( � � . <br />Engineers- ls �t � �, /i� �J� �_-c`, �t.,ti <br />Water ����L s9�frp <br />Slrccl <br />— �/ <br />