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(everen �' APPLICATION FOR RIGHT•OF-WAY USE PERMIT . � <br /> i,e so284 <br /> CITY ENGINEERS <br /> EVERETT, WASHINGTON PERMII'NO. �'� � <br /> The Undersigned_ L e V L.�AI �(�/-}S I r �I( �l� �✓ <br /> , Hereby applies for permission to�oUs r i�u � r i� ��S �� 1 ��� 7 U /t 4� <br /> i <br /> : At the followinp location � - �-a�. � � �, <br /> SKETCH - � ''.r ! L <br /> n <br /> ! (Work to he done� � I✓ ' <br /> ' �_ i <br /> � N�u) ,� s pK � nr�i � <br /> � <br /> i� � �. i <br /> � <br /> � � � i <br /> ; - I <br /> � 5015 j <br /> � o ! <br /> , � ' ; <br /> r� <br /> 1� <br /> � <br /> � INST/�LL il L�. � � � v �_,� r i <br /> i <br /> � <br /> � ' i <br /> � ` �' � <br /> 9' <br /> � � <br /> � N° i <br /> i sc9�-� ; <br /> � �nCt' �r �'t �sriric Rn�)n � <br /> � <br /> � <br /> I DHivEWAY SECTION P The undersigned owner heteby agrees m bold and � <br /> NO SCALE V <br /> � L- � � � save harmless the Ciry of Everett Irom eny and ell � <br /> � ZJ claims for damages ihat fnay arise because of installa• <br /> i" LIP _� � tion and maintenance of the improvement hereto I� <br /> ip � 3J�� I � applled�and further agmes to remove same upon ��, <br /> � � � � -�j�--"-�--'1 � notic�.trom the Ciry and to r lace public property � <br /> j x d �[hereby. � i <br /> �)II�W �B �J �(1U ��. L3�9namreofR�an ��SZlt ��L�� I <br /> __ _ __ 9- 2 � - 7s �� i� ,�,��k�e.� � AyJ <br /> i COPY Of= THIS nPPLICATION TO '' � Ad r s '. <br /> BE Pp$TEU ON J0�lSI1-E. I �� �.. F / � C-�C �/� ' I <br /> I CAL: FNGINEk;iiING D[PT. 259�881I i Telephoap�Number <br /> I 24 H(,URS BEFOHE cpNSTItUCTIONI Date \ ,�L� 1 Z� l� �J � <br /> I - �Z� ;o —r�,�,�rt Pc��� ' <br /> I CHECK LIST �� ,+ �� , Fee <br /> Watv Velve <br /> Drainage p App ovelf <br /> � Cwb&Gutter Engineer �c-�G ��Z-�� <br /> � Sidewalk j <br /> �,' Water s'_' �. <br /> � . �� �.;•� i ��CSireet- �!� —y�—� i <br /> Communications •��1----...e^. � r +' �>+' ' <br /> ; Inspector'sSignaNre �� : <br /> ' Traffic �� l- ` J S �� ', <br /> IPlannin � i �/ �r-� G )j � <br /> i <br /> ate <br /> �' Remarks � - - , <br /> i <br /> ��. Note: Original to Custamer <br /> �'� 1Copytofile 102R4 <br /> 1 CapY to Inspecror . APProve� -���/D � ; <br /> �' oece Appro�ed '� <br />