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-- APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br /> ev� <br /> 10056 <br /> � CITY ENGINEERS 7/L ' <br /> � EVEflETT,WASHINGTON PERMIT N0. /Y �7� • <br /> , The Undersigned ��gE12�T �--. S�. ��R. LL�2 <br /> � `\ � <br /> Here6y applies for pertnission to_�iC f�STR . b. 2 � ll� 1 �E �,$1�F{,«R11�FW�I. � <br /> --�— <br /> , At the tollowing location_ _� � q — �LPI 1J� p(Z � �' <br /> i <br /> SKETCH I <br /> . (Work to be done) I <br /> i I <br /> I <br /> I L U'? ( / � <br /> I No ' <br /> ' ScA�� I <br /> i <br /> I <br /> I e �9 i <br /> i ; <br /> � <br /> j <br /> i i <br /> , <br /> � � - i,� � <br /> � � � �_ <br /> � � � _ <br /> ' � pR. <br /> � <br /> � <br /> I /Q\a� <br /> i � <br /> IDfiIVEWAY SECTION � The undersigned owner hereby aqrees to hold and <br /> ' NO SCALE save harmless the City of Everett from any and all <br /> , �-- 21 �---� I claims for damages thet may arise because of tr.stalla� <br /> ' �� �i" LIP tion and maintenance of the imprrnement hereto � <br /> applied tor and furtber agrees to remove seme u�on � <br /> ��Q��-- -------+�30'� notice from the City and to replace public properry I <br /> demaged lhereby. j <br /> �/2� <br /> � A .��7 S g ature o Applicant -- �� <br /> �2� . .) �524 73R° Sr. � <br /> �I COPY OF THIS APPUCATION TU Address ' <br /> I BE POSTED ON JOBSITE. EVF(ZETf ' <br /> '� Tetephone Number <br /> '� CALL [NGW[ERI�IGDEPT. 259N811 ��� - � �S� � gZnR I <br /> I 24 HOUfiS ftEFORE CONSTfiUCT�UN Date � <br /> ; __ - _ ___ __ _ <br /> �l �--� r� � , �i-t ,� u. a � '� <br /> CHECK LIST Fe ,L�Q' <br /> Wanr Valve �EG'O (7�Tf��- Dept. Approvals <br /> Drainage � I�--�� ' <br /> � Curb&Gutter Engirleers _Tad��_�iu-�y I <br /> '� Sidewalk Water � <br /> Street C�� I <br /> �, �r..,. �no� �ommunicatiop <br /> Inspector's Signature '� , <br /> Tr�ffic <br /> ' . Planning �_ � <br /> �_��_ � � <br /> atD a I <br /> �� <br /> ,, cv , �- . �,��i � ;,��:, _ <f-17- 7�� ,�����, . � �. � <br /> emarks y } �.. <br /> Note: Origina� to Customer ' �/1 <br /> 1 Copy to File 10 0 5 6 �� <br /> 1 Copy to Inspector l�pprovedby �, <br /> �r. <br /> Date Approved <br /> 0�.: l 77'1' <br />