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Permit No.... ... ._..._ _.... <br />APPLICATION FOR DRIVEWAY PERMIT <br />CITY ENGINEERS <br />EVERETT, WASH. <br />The Undersigned i' t i t l t TN - t 6' iJ I. <br />Hereby applies for permission to r e / A I5 , <br />At the following location <br />SKETCH <br />(Work to be done) <br />6 / ST S T <br />T...... . <br />The undersigned owner hereby agrees to hold and save harmless the City of <br />Everett from any and all claims for damages that mu/ arise because of the <br />installation and maintenance of the improvement hereto applied for and <br />further agrees to remove some upon notice from the City and to replace all <br />public property damaged thereby. _ - - -- �;� SaCTI <br />(hJp SCAL::) <br />.DiiIv6\4AY S4CTION -: <br />Inspector s Signature <br />t IX 6-Z/. V <br />Dote <br />361.1 <br />11 <br />•� r•.t So <br />everett <br />Approved By <br />Date Approved <br />Variance Required <br />Yes <br />No <br />Signature of Applicant <br />Telephone Number <br />Dar 61,1 <br />$ <br />Fee <br />Remarks <br />