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Permit No. <br />APPLICATION FOR DRIVEWAY PERMIT <br />CITY ENGINEERS <br />EVERETT, WASH. <br />The Undersigned lam` L / E C '� � A-' t Appr <br />Hereby applies for permission to C d 5 T' `� a I�✓G '/ <br />At the following location <br />SKETCH _ ! (Work to be donel CIA eD <br />5C.ALE l" • 40 <br />Ine unaersignea owner nereur uy1cca 1v lluou w— ,..-. ..........-- .._ _..r _. <br />Everett from any and all claims for damages that mat arise because of the Yer .. <br />installation and maintenance of the improvement hereto applied for and No <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 />Sir _ ,; ,C"1� 79 , <br />Date <br />-�f~lys i if- <br />Signature of Applicant <br />/, <br />Address <br />Telephone Number <br />Dote <br />Fee / - Z V �' <br />DEPT. APPROVALS <br />Engincersl= � <br />Water— <br />Street— <br />