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Permit No.. �.everett <br />APPLICATION FOR DRIVEWAY PERMIT <br />j X, �e� <br />-Y oft <br />a N <br />CITY ENGINEERS <br />EVERETT, WASH, c, Approved By <br />The Undersigned Q^ s= t I F k CON 5-1 CO- Dale Approved <br />Hereby applies for permission to r'nu cro t rrY- A la' D/N! <br />At the following location c:—;,/ `— 8 �3 LL S T <br />SKETCH <br />(Work to be done) <br />887h sT <br />The undersigned owner hereby agrees to hold and save harmless the City of Variance Required <br />Everett fru.n any and all claims for damages that may arise because of the Yes _... <br />installation and maint.anance of the imprm,ement hereto applied for and { ��-� f 1 No _.. <br />further agrees to remove some upon notice from the City and to replace all <br />public property damaged thereby. <br />SSCftaN <br />.DRIVC�:'AY.�LfCT10N.. (N:� •�Jat":) <br />�oe <br />�JjQ�t/iss- t/i')l:( Lt �%t )v{, •,'erlrs r� <br />1 Signalure of Applicant <br />Address <br />Telephone Number <br />- / 4_ /-_f - <br />