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Permit No. .-.1.... - <br />APPLICATION FOR DRIVEWAY PERMIT <br />CITY ENGINEERS <br />EVERETT, WASH. <br />everett <br />,,e <br />Approved By <br />Dote Approved <br />The Undersigned L L4'Ll- <br />Hereby applies for permission to r onl r,T A /D it <br />At the following location ft� <br />)Z ND. <br />The undersigned owner hereby agrees to hold and save harmless the City of <br />Fereit from any and all claims for damuges 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 />.cflON <br />.L'RIVF:1d4Y (4GCTION..:" <br />�e <br />n <br />W <br />Variance Required <br />Yes <br />No <br />Signature of Applicant <br />Address <br />a 1 r/Lir7-1- <br />