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Permit No. <br />CITY ENGINEERS <br />EVERETIr, WASH. <br />The Undersigned <br />APPLICATION FOR DRIVEWAY PERMIT <br />Es <br />Ls <br />everett <br />0 <br />Approved By <br />Date Approved <br />Hereby applies for permissiot, toCA> N SZ r' , ,� �z 15- t U) I n C� t, t5f�lV 5Uj M <br />At the following location —70 GO J0 t 1 P1,`S <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 maimenonce 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 />{.� N lS}E--- <br />L� +I" LIP <br />7 <br />Variance Required <br />Yes <br />No <br />SignalurL of Applicant <br />Address "—_- <br />Telephon(e/ Number <br />Date <br />