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Permit No. /... .::/......... <br />6 <br />APPLICATION FOR DRIVEWAY PERMIT <br />CITY ENGINEERS <br />EVERETT, WASH. <br />The Undersigned t,3 LA . <br />Hereby applies for permission to --��:2T A, <br />At the following location I2-0 o—r*A <br />SKETCH <br />(Work to be done) BOTti S T, <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 />DRIVEWAY SECTION <br />NO SCALE <br />�I I" LIP <br />30" T 30" I <br />Inspectors Signature <br />_Ciy/rC�CJ i�1. T <br />Doff <br />Remarks <br />. U0 . <br />Approved By <br />Dote <br />•UC�T <br />Variant: Required <br />Yes.. ... .......... ... ..... <br />.. <br />No........................ <br />`) k Al <br />,+ Signature oI App'rcnnf �„s <br />`I ,i s r� ` r✓71j <br />'76- 7 - <br />Telephone Number <br />e- 29e, -73 <br />Dart. (7 <br />2a t p 61 bk, F. <br />f - c/--I3 <br />Wolof <br />k Street. <br />