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Permit No....✓.....--..... everelt <br />APPLICATION FOR DRIVEWAY PERMIT <br />-✓ r <br />u _ <br />a <br />Q' N <br />CITY ENGINEERS-- <br />EVERETT, WASH. V Approved By <br />The Undersigned J— EFED J-601 .50 0 Dom Approved <br />Hereby applies for permission to rah. dS T A / <br />At the following location 7/ S T / ! ACC y <br />IAIAV)5ieL Y AI -A G P44 T <br />SKETCH <br />(Work to be done) <br />I <br />.I <br />4r' , 1. P'vOPaSED <br />/ <br />—tU— <br />Pc oPose D <br />�'1 /' <br />GoPPER <br />Ale rF :. <br />I F D,e I Vf <br />P4Vr-p <br />6EFDCE /AVSTiy <br />LIN(r N/A14,eR <br />IWO <br />vrPLAuNG-I <br />j <br />r R 5 UTorF <br />oV T' 0� <br />PA UI+UG <br />ARF-A, <br />The undersigned owner hereby agrees to hold and save harmless the City of <br />Variance Required <br />Everett from any and all claims for damages that may arise because of the <br />Yes <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 />No <br />public property damaged thereby. <br />15 9 <br />i ( <br />1 . <br />Inspector's Signature <br />iT£�rfF <br />Date <br />nt _ <br />Remarks Engineers <br />Water <br />�', � (Olt /. . <br />Signature of Applicant <br />Addre:: <br />Telephone Number <br />Dale <br />Fee <br />DEPT. APPROVALS <br />