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Permit No. ........ <br />APPLICATION FOR DRIVEWAY PERMIT <br />u <br />A. N <br />CITY ENGINEERS a �� <br />EVERETT, WASH. z <br />The Undersigned r- P (::a 11 1 16 rf P1 - <br />Hereby applies for permission to C 614—TE urT A /D ' D <br />At the follow;ng location 0A11 ; P,�Ar'F <br />1A/1�1F P�Ac1= PL 1 <br />SKETCH <br />(Work to be done) <br />'7157' P/46E <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 />.DRIVE\VAY SECTION - <br />WA I It <br />Cf7., h <br />Inspector's Signature <br />Date <br />WNW,. SIC <br />(110 S:ALC) <br />3588 <br />everett <br />�e <br />�Approvecl By <br />Date Approved <br />Variance Required <br />Yes <br />No <br />_l r: C .n.. , <br />Signature of Applicant <br />Address <br />1.12 <br />/ Telephone Number <br />1.7 /(0/70 <br />Date <br />$ „r -ilPjV A '2 - <br />Fee <br />DEPT. APPROVALS <br />Rema ks <br />Engineers <br />Water / <br />Street <br />