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Pwmit No. <br />APPLICATION FOR DRIVEWAY PERMIT <br />CITY ENGINEERS <br />EVERETT, WASH. <br />The Undersigned tr• 9 • GA G N r'J-j <br />everetl <br />�e� <br />Approved By <br />9 _ <br />Date Approved <br />Hereby applies for permission to �—Q� STIZ _ Ns' P" , D O U6 oj /� `i <br />At the following location C 7.4 5� --- <br />SKETCH <br />(Work to be done) <br />Gos,sTR. 1 i I-lP To <br />srr�r p/.'-gIUAG� FkroN <br />---- �60trvt; DaDt'i to pat tl&tljA,l <br />zo' - > L r,y <br />S T <br />/730 <br />EX. C0NGRrT1 — <br />DRIVEWAY PAD5 <br />/07 <br />39 <br />The undersigned owner hereby agrees to hold and save harmless the City of <br />Everett from any and all cloim,, for damages that may arise because of the <br />installation and maintenance of the improvement hereto applied for and <br />further agrees to remove somu upon notice from the City and to replace all <br />public property damaged thereby. <br />DRIVEWAY SECTION <br />{�--NO SCALE <br />I "Lip <br />30" 1 <br />Io�.l�^73 ! <br />Inspector's Signature <br />,t51T(— CNEci<t�D y-15-7� <br />Date <br />Na <br />SGA L[. <br />Variance Required <br />Yes <br />No <br />/ Signature oF Appl' ant <br />Y-- Address <br />3s3� 3/gS <br />Telephone Number <br />` -18, -? i <br />Date <br />s /e2, 5.i1414) 9-/P-7-C <br />Fee <br />7-ice �3 <br />Remarks <br />Water <br />7/z S-/73 <br />