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Permit Nr ..;. .. ..J �^ <br /> E'VP.Cf'tt <br /> APPLICATION FOR DRIVEWAY PERMIT <br /> CITY ENGINEERS <br /> EVERETT, WASH. proved By <br /> oc-4nb� 29. Rocs <br /> �• Dale Approved <br /> The Undersigned , �%��- :-./-1 j �--�' � f <br /> Hereby applies for permissior to��'/ <br /> At the following location 7t�,� <br /> SKETCH ' <br /> (Work to be done) _ <br /> I' <br /> CI;L ;in/O � "I <br /> DEPT. 1 �i� dE <br /> LOCATIONS BEFORE EXCAVATION <br /> � <br /> coA/sr. ¢. 4s:e v,i✓�'s v, <br /> 4'K,c. <br /> `J <br /> NOTE <br /> CHECK WITH W TER <br /> DEPT. FOR WAT .R UN�� (� \ <br /> L,OCAYIONS BEF RE G ,VATION <br /> The undersigned owner hireby agrees to hold and save harmless the C'ty .I Variance Required <br /> Everett from any and cd claims for damages that may arise because nre Yes <br /> instnllalion and maintenance of thn improvement he,cla applied for I No <br /> further agrees to remove some upon notice from the City and to replan 411 <br /> public property damaged thereby. pp ,/ <br /> d"q C'ttzcCe^t- <br /> w <br /> .��•�/7D Signclure of Appliconf <br /> Address <br /> Telephone Number <br /> Dale <br /> Inspectors Signeure $ <br /> Fee <br /> bore, <br /> DEPT. APPROVALS <br /> Remarks EntWater vc <br /> Water <br /> __ Street .--- <br />