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Permit No... `T...- <br />APPLICATION FOR DRIVEWAY PERMIT <br />CITY ENGINEERS <br />EVERETT, WASH. <br />The <br />Hereby applies for permission <br />At the following location <br />SKETCH <br />(Work to be done) <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 some upon notice from the City and to replace all <br />public property damaged thereby. <br />Inspector's Signature <br />Date <br />everett <br />�,e <br />Approved By <br />41'16; i s: % /9iD <br />Date Approved <br />I <br />Variance Required <br />Yes <br />No <br />j)It4c.H1 <br />$r1zN19izD I�ntNOOK- <br />,�.. L�tal�—_ <br />Signature of Applicant <br />$l�iss,Y ':wnONUS <br />Address <br />Au- RsF(0S <br />),•;.I Telephone Number <br />P- G r70 <br />Date <br />$ La_ �j_3ya8 <br />Fee <br />rr DEPT. APPROVAL <br />&7l L UZ- <br />_T Engineer; _ <br />/ ✓ Water __.CK— <br />