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Permit No. <br />CITY ENGINEERS <br />EVERETT, WASH. <br />APPLICATION FOR DRIVEWAY PERMIT <br />C 0A-1 5 <br />everett <br />,e <br />c -- <br />Approved By <br />2z /9r"D <br />Dale Approved <br />The Unoersignecl <br />y = � CU Dr IVEWAY AMID REPLACE <br />Hereby applies for permission to Cam~" s � / /U <br />dn/C CU eP <br />At the following location <br />SKETCH <br />(Work to be done) <br />Go�G, <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 becaise of the <br />installation and maintenance of the improvement he'rets, applird for and <br />further agrees to remove some upon notice from the City .end to replace all <br />public properly damaged thereby. <br />circrion <br />{NO SCAL%} <br />Y so <br />LIP _.. <br />_ �Q/ <br />Inspeclor's Signature <br />7-0 <br />.3 <br />V_DRIVOMY S4CTION <br />rca!ti��L ^ /�• <br />Variance Required <br />Yes <br />No <br />$ignolure <br />r ) <br />Telephone Number <br />Dale <br />$ <br />Fee <br />,F <br />