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Permit No. /:... ... ....... _... everett <br />APPLICATION FOR DRIVEWAY PERMIT <br />CITY ENGINEERS '" <br />EVERETT, WASH. Approved By <br />The Undersigned �ali' E.12T W <br />�r%(2.{z��� Date Approvedr <br />Hereby applies for permission to 1 N S TA L L U10r,DEr T�oS T C> N G IZ y 1 O f� AFPIZU]r Zia' <br />jc:�?n44 112-10sA)(e nA) 14iQ Z AlkJ1.J <br />At the following location cA o S tS-7 s '7' S F <br />SKETCH <br />(Work to be done) <br />749 <br />No seni-5 <br />t, <br />�1eTE� pos'r To Or APPn-ay. <br />a.KPub?E , 3��� T3CL-9KO aV--aurao 4i <br />At3csoe Cor1600e '4' S orV CENTEk. <br />EA13 r/A/G 6r <br />MAGDALEN <br />-EKs T <br />ST. Mf.2y <br />FtvTtz r4a- <br />Ro AOW A v <br />♦ • o <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 o' 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 SCr �T <br />11 <br />Variance Required <br />Yes <br />No <br />Signature of Applicant <br />Address <br />