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Permit No. / ,r ... everett <br />APPLICATION FOR DRIVEWAY PERMI1 <br />CITY ENGINEERS _ <br />EVERETT, WASH. Approved By <br />The Undersigned �klIi-rP- _ Date Approved <br />Hereby applies for permission to r^^' �c r(� A 2S1 W I [�� rjti �g2pU D <br />4c l: r\ q�st2tLl 1C C' 1 P L?ISC n� ll�t T� Et�ST V� y',''. I nJ -- <br />At the following location 1 1?) 0 -�!, l: T S ✓� - <br />SKETCH <br />(Work to be done) <br />00 Sr -ALL <br />-�3 _5 r _ _ l_ _ _/ <br />e'x/sr1AS /MLET. <br />PfuatnsncE ro f3e <br />Dlf?mTGn 1AIM /NGE <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 same upon notice from the City and to replace all <br />public property damaged thereby. <br />DRIVEWAY SECTION <br />NO SCALE <br />— L3' <br />j I" LIP <br />r 30Wl <br />I . �f.—. <br />Inspector's Signature /C;11105 <br />/y" IOU <br />Date <br />pRnoa-4eo oa110SL.,A4 <br />Pszer�eb_YMt�u A+4Tr►. <br />XIST, 6"C-uRb <br />15- uJA-rE2 VAuJg <br />Variance Required <br />Yes <br />No <br />Signature of Applical <br />l �) : , Address <br />Telephone Number <br />/7- 73 <br />Date ^ -7r <br />/ 7 <br />fee <br />Remarks <br />r <br />