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franit No...L...sZ>..l. `. .- <br />��� � everett <br />APPLICATION FOR DRIVEWAY PERMIT <br />CITY ENGINEERS <br />EVERETT, WASH. Approved By <br />The Undersigned AQ-n � � � ���= Dale Approved <br />Hereby applies for permission to '��N�T� - �_ t S I tj I 'Il4 aw <br />At the following location—:;i2� J I.S,2 % S� S <br />SKETCH <br />(Work to be done) <br />El <br />EXIST/NG GUL I/GRT __ <br />IDr <br />C. —C,QL, —EOr.e OF PAVtT <br />Zt�Lr - I EX, CONC12. + <br />UJ MINIMVF{ pRIVC?WAS! 5LAE, <br />25/ 0 <br />15 -- — <br />I <br />4 <br />I& <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 novice from the City and to replace all <br />public property damaged thereby. <br />DRIVEWAY SECTION <br />NO SCss LF, <br />I" LIP <br />30�3U <br />r AV ' T <br />Inspedor s Signature <br />/71--- IECV,122 /0-SLZ,.3 <br />Dote <br />Remarks <br />Vo. ionce Required <br />Yes <br />No <br />Signature of A p(i ant <br />10-7?,4' cT- <br />Address <br />Telephone Number <br />Date <br />�y(:' -3 - � � Fee <br />No <br />SCALE <br />•DEP APPROVAJ�6 <br />Engineers _ Z /O I 3 <br />Water 411. <br />Street <br />