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APPLICATION FOR RIGHT-OF-WAY USE PEhM1T <br /> . everetl �O p L+ <br /> e vv <br /> � <br /> CITY ENGINEERS <br /> EVERETT,WASHWGTON . PERMITN0. ' � � 7 <br /> The Undersigned [ ' � � .___ '� <br /> Hereby applies for permission to � I y `� ��� ✓� i i� i z � r� 5r'ii �: �T ��tJ � <br /> -� / .. <br /> At the following Ixation 7 '/ 2 ��- +`� �i f�/1 J t, ����� . ' , . <br /> SKETCH ���. <br /> (Work to be done) . <br /> � j�:�r /� '�.-1,: N`S,� .. <br /> i <br /> I il <br /> ! I <br /> � �i <br /> i . ,. . � . � . �.,� � , � . . . <br /> i � . . . � � . . . � .. <br /> I .. . . � .. � . . � � .. . ... . .. <br /> I <br /> I <br /> � <br /> I <br /> � <br /> i <br /> I <br /> I � � <br /> I <br /> I <br /> I <br /> ORIVEwAY SECTION The undersigned owner hereby agrees to hold and <br /> NO SCALE save harmless the City of Everett from any and all <br /> � r-- � claims for damages that may arise because of installa- � <br /> — +�„ ��P—�� tion and maintenance of ffie improvement hereto <br /> . applied for and further agrees to remove same upon <br /> � , 30" ._ 30" notice from Me City and to replace public properry <br /> � dama t reby� � <br /> � <br /> �, Signature of Appticsnt . .�/ <br /> I� � �. (� . ?�7S ��i.r��-G��7o� . <br /> ' CI pPY OF THIS APPLICATION TO � A'ddress <br /> � BE POSTED ON JOBSITE. � 3�' 3 4'"�t� � <br /> ' CALL ENGINEERING DEPT. 259-8871 Teiephone Number <br /> '�. I24 HOURS BEFORE CONSTRUCTION Uate . � // <br /> . ' L�_ ____ — -___.— �. " ' =�11' <br /> � CHECK LIST F� r � <br /> . Water Valve � Dept. p Ovels <br /> Drainage �r ��� <br /> , Curb&Gutter � �/f � '�� tngineers G� ��G/r�v1' — <br /> � Sidewalk ������ Water � <br /> Street _ <br /> � Communications <br /> � Inspector's Signature Traffic <br /> ', Planning . <br /> at�e <br /> Remarks <br /> Note: Original to Customer <br /> 1 Copy to File � (1�?6 <br /> 7 Copy to Inspector � Approved by <br /> Date Approved <br />