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everep __ APPLICATION FOR RIGHT-OF•WAY USE PERMIT <br /> � e � - 10891 <br /> CITV EN�:�NEERS <br /> i EVERETT,WASHINGTON PERMIT N0. 77—/ -r/O <br /> I The Undersigned�,:r� � O� s��a <br /> , Hemby applies for pertnission to�,_a��r �� i.,-�, � ✓i �� _� � r���� ^Y _ � r <br /> �;�y _� � r�Li � , : t xivr ' <br /> � At the following location 3 1_ S ia_�.�c , / <br /> i SKETCH <br /> (N'�rk to be done) <br /> S �� l�T.�C H s p � <br /> � I <br /> I <br /> I <br /> I � <br /> � e. <br /> , �. <br /> � � <br /> � � <br /> : <br /> � <br /> � <br /> : <br /> � <br /> � <br /> i DqivEWAv SECTiON The undersigned owner hereby ag�ees to hold and <br /> , NO SCALE_— sava harmless the City of Everett from any anJ all I <br /> r----- � claims for damapes that may aiise because of tnstalla• <br /> I1�" L�v -�� tion and mnintenance of the improvement hereto <br /> i j� I applied for and further agrees to remwe sama upon �� <br /> - � -�--,M n ce � Ciry and to replace pu6lic properry � <br /> � d er <br /> I <br /> , igna re of App icant ' <br /> —__ __ ____.._ _ �eaL� cOl�.� <br /> � COPY Of THIS APPLICATION TO � Address � <br /> BE POSTED ON.IOBSITE. �' �� ( �-�� j <br /> iCALL ENGINEERING UEPT. 259�8811 I Teleph�e�I�ur�ber7 ' <br /> , 24 HOURS 6EFORE CONSiRUCTIONI Date / � � <br /> CHECK LIST Fee;�'�/" �" � <br /> � Wat�r Valve + <br /> Dreinage Dept. ApprOValf , <br /> • Sid W&Ik utter Engineers_l�� ��f,.�`. - <br /> — Water <br /> S[reet <br /> ! Inspectoi s Signature Communications � <br /> , Traffic <br /> i Planning <br /> el�e----- — '' <br /> I <br /> Remarks <br /> i <br /> Note: Original to Customer ' <br /> ' 1 Copy ro File 10891 I <br /> � 1 Copy to Inspector AuorovxA hy � <br /> Date qoproved I <br />