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Permit No. ... _ ... .. _.. ... _ everett <br /> APPLICATION FOR DRIVEWAY PERMIT <br /> CITY ENGINEERS <br /> EVERETT, WASH. Approved By <br /> �fHecs� .�.5 <br /> The Undersigned L I Date Approved <br /> Hereby opplir for permission to <br /> - <br /> 1 ---- <br /> /0 - <br /> At the following location 7 / <br /> SKETCH <br /> (Work to be done) — -- <br /> TH <br /> Swefh <br /> t1lo.vis. <br /> _10.0 it n p u <br /> s. <br /> aro <br /> -j g 9 to I Iz II 3 <br /> (0 5 4- <br /> The <br /> The undersigned owner hereby agrees to hold and save harmless the City of Variance Required <br /> Everett from any and all claims for damages that may arise because of the Yes............................ <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 .3616 <br /> public propertt do_aged thereb . <br /> D.HlY sifZAY 5[C'TIUN <br /> (>Jo scat^) DRIVE WAY . SCCTtON.:_:" <br /> U fir./-u� � � �✓ <br /> 9 <br /> Signolure of Ap icon) <br /> 30" <br /> Address'----� <br /> y^ + j p - $e•I d s•y Telephone Number <br /> Q- <br /> L._.�_----- _. <br /> ZZ <br /> Date Daterr, <br /> Inspector's Signature $ `pc` �de. "G I7/ <br /> Fee <br /> Date <br /> DEPT. APPROVALS <br /> Remarks Engineo <br /> - zf17/ <br /> Water r- <br /> 71 <br /> Street -- <br />