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everetl <br /> APPLICATIOPI FOR RIGHT•OF-WAY USE PERMIT <br /> e �00� 8 <br /> CITY ENGINEERS <br /> EVERETT, WASHINGTON PERMIT NQ �� <br /> The Undersigned .-?C)V N I� �A_ ��E T � , <br /> Hereby applies lor pe�mission to �_ I� G �T ll _ <br /> At the toilowiny location � � <br /> Z�� 1C��.---- - <br /> SKETCH ^` <br /> (Work to be done) � <br /> �\10 <br /> __,�.r-•--..r I <br /> F�v �.-�ot� S`T No �Y��w� <br /> \��r <br /> C�� � <br /> , �� ��� <br /> � n��° ��P � <br /> ►� V �� � <br /> J � <br /> � � C�` r <br /> ���, r <br /> �Ro P�t� � �(/� � , � <br /> F�� ��� �� � ��� <br /> � �'� �� - , , . <br /> � �b' <br /> 6 AIC� R p.vC <br /> DRIVEWAY SECTION The undersigned owner hereby �grees to hold and <br /> NO SCALE save harmless ihe City of Everett irom any and all <br /> �-��-� � � - �� - -� clanns fm damages tha7 may arise because of installa� <br /> �i Lip �1 tion and maintenance o� the improvement herelo <br /> �70'+_ _ I 30JI appiied for and tu�iher a9rees to remove same upon <br /> ` -��1' - �1 no{�ce(rom the Ciry and to replace public pfqperty <br /> da/r aged �h ¢�y. ; / � - �J%// -,r <br /> KJ,c+,_, �` ��t�L � ! �-�/. :6-4�.;. <br /> Signature o(Applica t �- <br /> 1 � � . <br /> I <br /> � OPYOf IHI`; .�PPIJi.:i;lir)p� IU ���� ' Address� �- ��� � <br /> R[ POSTEO ON JOBSITE. , � ��� � � <br /> �'/�i I EN�,ir:[I R�F�G I�F PT ?�,�� ':.�. � . TelePhone�Number <br /> ,'1 ��,i ill�:., � �. liii � , , . , _'—_ "__"_.— <br /> - � �� � ��. Date - ; .� --� <br /> �_._ . �/ ' �•- . ' <br /> CHECK LIST ---t---�-_-_.___'_�---- <br /> Watei Valve Fee <br /> Drainage b� .� � Dept. Approv&IS <br /> Curb& Gutter n ��' n G <br /> .___ � Engineers ��/_� �� <br /> Sidewalk �---- �� <br /> . . - ---.__ _ _ ....--- <br /> ----�- - Water <br /> ----- - <br /> ---------- <br /> �'-c-=�- - --- �-�---.. <br /> ---. - ._. . . Traffic�f io s:- <br /> _ ..__.._-- ------ <br /> e _ <br /> Cornmunicat <br /> Inspe�;tor's Signature ,�j I � - <br /> Planning�✓ , ai4�I��7� <br /> -6atc ----- --- - �,x7.�-.a-'vt�� ._j '�`. - <br /> ---------_. - ----- - <br /> Remarks - — -. <br /> Note: Onpinal to Custumer --- - � - -� <br /> , c���Y ��,r�i�� 1 n .^, ,� o — <br /> � � <br /> 1 C��py to Inspecfni APPraved by <br /> _ . . _--.-__-_ <br /> ___' _ <br /> Date Approved � � <br />