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Permit No '� _ ._._ .` ._ . . <br />CITY ENGWFERS <br />EVERETI', WASH. <br />The Undersigned <br />APPLiCATION FUR DRIVEVJAY �ERAAlT <br />JJ /J / :� <br />everett <br />� <br />��;"li,�.��� <br />Approved By <br />�i/�y _3I %y ,',; . <br />Dote Approved <br />Hereby applies for permission to PR V F F Xl � r --'2� � �� � W�%�� C�N���F�r <br />At the following location <br />SKFTCH <br />IWork to be dune) <br />_ \, -------. <br />� _ � -- i <br />N p T'7�C :; <_� �J t.. d:� <br />The undcrsigned owncr 6ereby agrecs to hold and save harmless the Cily of <br />Everett (rom any and all claims for damages that may arise because o( the <br />i�stallotion and maintenanm of thc impwvemeM hereto applied for and <br />further agrees to remove seme upon nolice irom Ihe Ciry and lo replace a!I <br />pu6lic property domciged fhcreby. <br />� <br />� ' �i�te_j9-- '��� �i� /� — � <br />Incnoc�,r's Sig� <br />i <br />_�_ ,- _ ., _� � ��Jl <br />Daic <br />P.crnarks <br />� <br />I <br />{ •' <br />IJ <br />T <br />� <br />� <br />a �� <br />0 <br />.� ;�'t.r;. <br />��i5 �' <br />� g- i � �'% �'�- <br />��,�,�,; <br />V,^ A��. � <br />Variance Required <br />Yes. _._.__...... __..... <br />No. _.._........_..__.. <br />, <br />Signalure of Applicanf <br />_ / y . <br />Address <br />. -� i <br />ielephone 'lumbur <br />;�, <br />Datc <br />S /�1C? /�'f'" - - <br />[Yt� <br />DEPJ.. APPROV�LS <br />'7// ; <br />Enginrcrs ..��/(r �l�%�`// � <br />'r"✓alcr_.�� ----'- <br />