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PermitNo..XCQs 1.... everett <br />APPLICATION FOR DRIVEWAY PERMIT �e <br />CITY ENGINEERS ajr <br />EVERETT, WASH. roved By <br />The Undersigned— i AA-ralQ L MoRGs -tDate ""pave <br />Hereby applies for permission 'o.re_s6T2.X A one Asps_IAsTsc CorsCft6'CE bwJ <br />At the following location E3t_bcseJ— <br />SKETCH <br />(Work to be done) <br />N <br />q-- <br />75'w CLEARANCE FROM P/L REQUIRED <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 />nI <br />rV <br />Inspeclor's egnature <br />Date <br />Remarks <br />0k <br />Variance Required <br />Yes ._.._.__ _..... <br />No_........_..... <br />Signature of Applicant <br />Address <br />Telephone Number <br />Lire <br />S <br />Fee <br />DEPT. APPROVALS <br />Engineers — <br />Wale: _ -- <br />Street-- <br />fnrnmunirnlions� <br />