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PermitNo. .. ..........�..... everett <br /> APPLICATION FOR DRIVEWAY PERMIT <br /> CITY ENGINEERS <br /> EVERETT, WASH. Approved By <br /> The Undersigned ( A iZM I G 14A1E L— Date Approved ,\ <br /> Hereby applies for permission to CDM 72-1 . ` 1 r ' �t �1) C d N k( V EW A� <br /> At the following location 1'� I cO — U -T I-1 —�• �, • <br /> SKETCH <br /> (Work to be done) O Ti—t <br /> _ ST. <br /> i <br /> No <br /> IJ l <br /> LL <br /> 1M /ui <br /> / e)'l J I LY <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 urine because of the Yes _. . ..... <br /> installation and maintenance of the improvement hereto applied for and No <br /> further agrees to remove some upon notice from the City and to replace all <br /> - <br /> public property damaged thereby. <br /> DRIVEWAY SECTION <br /> NO SCALE <br /> Signature <br /> 't-I o// Applicant <br /> I LIP lcI (D �J_ BIi\del. <�'��K' ti- <br /> Addr� t <br /> 30" <br /> Telephone Number <br /> 9�el /e/ Date <br /> ImpSignafure <br /> � r • j <br /> I� -EC <br /> Date 6 <br /> DEPT. APPROVALS <br /> 7 <br /> t Remarks Engineer11 ,' �t.l <br /> I Water _ <br /> Street <br /> Communi,uliont ' .. —r� - <br />