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APPUCATION FOR RIGHT-OF-W,aY USE PERMIT <br /> �'4�retl .. . . . _ . <br /> . � <br /> CITI' ENGINEERS <br /> EVERETT, WASHINGTON PERMITNO. ..,__. ___ . . <br /> The Undersigned =__'_'.__�_ � ` -�— <br /> Hereby applies for permission to � r. '�r, ;.� '!" /� 'J_���;��' M i7 ! 7" ��Y � '�-� �' / ----- <br /> At the following location_. ° -'� �� -� � � (' '-� � " ` <br /> _ ___.. ._.. <br /> SKETCH <br /> _____.---- ------.—._.___-- .___. <br /> (Work to he done) <br /> I <br /> 7� <br /> , �� � <br /> DHWEWA� SECtiON The undersigned ownen c�rc6y a,yrees to hold and <br /> NO SCALE save harmless the City ol Lve�ett trom any and all <br /> �. -- — claims for dama9es that may arise because ol installa� <br /> _ - -------------T tion and maintenance ol the improvement hereto <br /> ��______L—��P .---.-..--.� J rpp�i�d to�and tur�her a9rees to remove same unon <br /> �30',,,� � � � � .,. ��. notice irom the Ciry and to replace puhlic properry <br /> 3 D' <br /> ' ' dame9�� thereby. <br /> SiGnature uf Appl�'cant � � <br /> .� . . _.�._R;3,�,.�....,:..;�..�- <br /> . . � Address _ � ---- <br /> COPV OF 1HISAI'PLICAIION 10 � <br /> I4E POS'ED ON JOBSffE. '�, Telephone Number � . - <br /> �'M.L ENGINEERING DEPL 259�9811 i ,______ _�____�.—_ -_ . . . . <br /> . '� IiUUPS C�fOHE CONSTRUCTIONI Date <br /> CHECK LIST � Fee � <br /> Wate� Valve Dppt. Approvals <br /> Drainage <br /> Curb &GuUer � Engineers_ —. �— <br /> Sidewalk Water_ <br /> K Stree;_ <br /> Cammunications <br /> ..Inspec�m' W�e Traffic_ <br /> t� L Planning <br /> . i_.~ ���`_-- -- -�- <br /> 6r�e - <br /> Remark.� . - . . .. <br /> Approved by <br /> DaP� APp�nv��d _.'---.—_. 0 <br />