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Permit No.. — ........ 7 ('vere11 <br />,"%PPLICATION FOR DRIVEWAY PERMIT <br />CITY ENGINEERS <br />r <br />EVERETT, WASH. Approved By <br />The Undersigned N A. L Q F AC k O F N E 2 Data Approved <br />Hereby applies fo• permission to C OA) S T 7'11/,,) D U P L !: X <br />At the following location z % z / o E ':-L' 57-- <br />r� <br />6 3 rd. <br />The undersigned owner hereby agrees to hold and save ho,mless the City of <br />Everett from ony and all claims for damages that may a ise 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 properly damaged thereby. <br />fnspector's Signature <br />Dote <br />9 <br />S T, <br />Variance Required <br />Yes ...... <br />No_ .......... <br />•�' Signature of Apelicant <br />Address <br />y <br />Telephone Number <br />Date <br />$ /2!2e F_-IL/ <br />Fee <br />DEPT. APPROVALS <br />Engineers -^ <br />Water <br />Street <br />