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Permit No. —� ....... <br />APPLICATION FOR DRIVEWAY PERMIT <br />� <br />r <br />J <br />)0 <br />f <br />ti <br />CITY ENGINEERS o <br />.9 <br />EVERETT, WASH. r�J <br />The Undersigned G P- LA I. l L A M B F <br />Hereby applies for permission to C6N57—, A le <br />At the following location O -Y zc' ,4C <br />SKETCH <br />(Work to be done) <br />F-- <br />3 <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 may orise 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 />vGi 5tC <br />(NO SCAILC) <br />Inspectors Signature <br />Date <br />? 6 G I i <br />everett <br />,,e <br />' Approved By <br />Date pvecl <br />Variance Required <br />Yes <br />No <br />Signature of Applicant <br />Address <br />Telephone Number <br />Dote <br />$ .h�CCn <br />Fee <br />Remc <br />DEP APPRUXAIS <br />Cngineert-s+1-1-� <br />Woter�.t2—�— t c7/ <br />Streets_ -- <br />