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'Permit No...l._-... L.._.. <br />APPLICATION FOR DRIVEWAY PERMIT <br />CITY ENGINEERS <br />EVERETT, WASH. <br />everett <br />�e <br />Approved By <br />The Undersigned t) S s F_ / ` A [ LA fZ 11 Dare Approved <br />Hereby applies for permission to F/ L L Fj2 J/-f F OG E ?F PA'JFI/F_'N !' `6k- e D, W <br />T!/E k'JFA'WA) Aare TfI/s /3 To PA2k Nrs CAR /3ECAUSE r9F 786 S72TAP 1111G <br />At the following locationz 279— i� Z &d `37 <br />SKETCH <br />(Work to be done) <br />6 2 nd <br />lWX: TEtfPa2 n2Y <br />UNTIL STQEErIS <br />,TNP2oVC a, „ <br />The undersigned owner hereby agrees to hold and save harmless the City of <br />Everett from any and all claims for damages that may 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. <br />OWA/1s(Z IUevGU LACE <br />GIs Gig«v IN ro p4gAe <br />N 15 CAR. <br />Inspector's Signature <br />Date <br />tJ. <br />EXIST <br />D10) usr�s ae rjLotKED <br />ST. <br />Variance Required <br />Yes <br />No <br />Signature of Applicant <br />Address <br />s' cA q, <br />f [Telepho•re Number 7 <br />3 8 214 Date <br />$ O / " t "- <br />Fee <br />EFT. APPROVALS <br />r> <br />Enginefrs <br />Street <br />