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Permit No..1..... <br />APPLICATION FOR DRIVEWAY PERMIT <br />CITY ENGINEERS <br />EVE R67T, WASH. <br />everett <br />�e� <br />Approved By <br />zz ,L/" /.r? /g7/ <br />The Undersigned � t i L 13E Date Approved <br />C.� ��Q.l — <br />Hereby applies for permission to (16& srre 0r T` A / D b1/JQ <br />At the following location ;7 <br />/ 1 Pj. Ac[= <br />SKETCH <br />(Work to be done) <br />The undc.signed 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 same upon notice from the City and to replace all <br />public property damaged thereby. <br />.DRIVEWAY.. SECTION . <br />10 SC&I! <br />Signalure <br />Date <br />y51C <br />(NO Se.ALC) <br />. 80 <br />Variance Required <br />Yes <br />No <br />;nature of Applicant 7� <br />Address <br />Telephone Number <br />170 <br />Dare <br />$ <br />Fee <br />DEPT. APPROVALS <br />Engineerse <br />Water <br />