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Permit No. ..................... everett <br />APPLICATION FOR DRIVEWAY PERMIT <br />CITY ENGINEERS <br />EVERETT, WASH. ` Approved By <br />/t N 1,�/3 <br />The Undersigned L A/Z (Z Y M' M C C O `� Date Approved <br />i <br />Hereby applies for permission to <br />JC�sI-L=C:4 WAY <br />At the following location Jr oZ S 7 4 76 7— <br />SKETCH <br />(Work to be done) <br />8/ /cpaA)t'j C� <br />74`T-u 5T <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 opplied for and <br />further agrees to rem-ve some upon notice from the City and to replace all <br />public property damaged thereby. <br />DRIVEWAY SECTION <br />NO SCALE �! <br />Inspectors Signature <br />5iTo: r,/F 1-5.11EIJ <br />Dole <br />Vnriance Required <br />Yes _. ...... <br />No <br />nature of Applicant-----' <br />Address <br />3�;- 3-- J d40 <br />Telephone Number <br />Date <br />$ No FE'E <br />` I Fee <br />Remarks <br />-J - <br />Water � -IK— _t"t'Fi 1�tV <br />Street ` 2 ^ :L..-L <br />Cammunirotiont uhie'' • � '� "•`-"` � <br />