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-�, <br />Permit No.7� eVereYl <br />APPLICATION FOR DRIVEWAY PERMIT <br />CITY ENGINEERS , <br />EVERETT, WASH. Approved By <br />f , C. r.,t : r- t � r r� L' [ rJ I Q Dale Approved <br />The Undersigned �i-- — <br />r <br />Hereby applies for permission to G S T Ic' _ 3 LV \ P L fJG D lz VIt' o*N j <br />At the following location 02� G -7 - Z 2 N" :5 T- <br />SKETCH <br />(Work to be done) <br />I <br />18 <br />92 Nam' 5-T. 5.tf . <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 same upon notice from the City and to replace all <br />public property damaged therehy. <br />DRIVEWAY SECTION <br />NO SCALE <br />—+I" LIP <br />i <br />Inspect 's sigrtaluro <br />i <br />Variance Required <br />Yes <br />No <br />f � <br />Signature of Applicant <br />Address <br />Telephone Number <br />Dale <br />o -7� Fee <br />7'�` <br />