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Permit No. /. <br />APPLICATION FOR DRIVEWAY PERMIT <br />u c <br />u <br />N <br />CITY ENGINEERS F .y <br />0 <br />EVERETT, WASH. v <br />The Undersigned <br />Hereby applies for permission to r ou STQ A 1 ' DIW <br />evereH <br />�.e <br />1 i / <br />Approved By <br />At the following location 1,6 /-y- Z/ aT PL <br />WAVE91 V pl_.ac-i—= PI -Al - <br />SKETCH 7 <br />(Work to be done) I <br />-72- ua 5-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 arise because of the <br />installation and maintenance of the improvement hereto applied for and •� C 11 <br />further agrees to remove some upon notice from the City and to replace oil V 0 t. <br />public properly damaged thereby. <br />URIV&1JAY ,LCTION <br />Imixclor's Signature <br />.5229: CN C/-c%� i/�/ <br />Date <br />W rIWAY, :SEC <br />(NV BCMi) <br />.� .... _ ...1+.. _ 30N <br />o <br />0 <br />G <br />Variance Required <br />Yes <br />No <br />r <br />Signalure of Applicant <br />,r .. <br />Address <br />Telephone Number <br />Date <br />Fee <br />DEPT. APPROVALS <br />Engineers <br />Water r <br />Street ---__--. <br />a.. <br />