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Permit No. .. <br /> everett <br /> APPLICATION FOR DRIVEWAY PERMIT <br /> CITY ENGINEERS <br /> EVERETT, WASH. Approved By <br /> The Undersigned �2E 1��R I< <� 4-f�,Ft��15- Date Approved ' <br /> C:,fQ AVE L <br /> Hereby applies for permission to R 1 U Eli�Ay <br /> At the following location 4 �' -rte ST <br /> SKETCH I <br /> (Work to be don I <br /> N° rq MR <br /> I i I <br /> I <br /> WAr svvr�Ff 7o- cc <br /> IF /T /S W171-15-0 <br /> 1V 77 �YE Wily /, <br /> Ili 40(0 <br /> Irl <br /> I � I <br /> � I} <br /> I <br /> The undersigned owner hereby agrees to hold and save harmless the City of Variance Required <br /> Everett from any and all claims for damages that may arise because of the Ye. _... <br /> installation and maintenonce of the improvement hereto applied for and No <br /> further agrees to remove some upon notice from the City and to replace all <br /> public property damaged thereby. <br /> DRIVEWAY SECTION Ye- <br /> NO SCALE Signature of Applicant <br /> r <br /> 2-1 <br /> ' --- _ <br /> I" LIP Address <br /> Telephone Number <br /> 1 Dale , /•3/- 73 <br /> ci <br /> Inspecloi s Signature $ <br /> Dote 1 <br /> U PT. APPROV,I.S <br /> Remaks Enginepf <br /> Water <br /> t ---- ---- V Street aS.L . n?nom•.. L.. _ <br />