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everen APPLICATION FOR RIGHI"-OF-WAY USE PERMIT <br /> � 10894 <br /> CITY ENGINEERS <br /> EVERETT, WASHINGTON <br /> PERMIT N0. � � ��' % � <br /> 0 <br /> Thr Undersigned_i; U,a�.i,� ,. .,, e_i�tt � ( ! i . _ � <br /> , �------ <br /> Hereby applies for permission to ��u n,• -',7 � � � � .- • — <br /> 5 t <br /> At the following location_,�p�_ " ; 3 �� )�, � K. <br /> SKETCH — <br /> (Work to be done� <br /> S i=E fF�i�Ci-1-4 <br /> DRIVEWAY SECTION The undersigned owner herehy agrees to hold and <br /> NO SCALE save harmless ihe Ciry of Evere[t (rom any and all <br /> �� - _ __ � claims for damage; that may arise because o} installa- <br /> ---��" ��� __� tion and maintenance of ihe improvement hereto <br /> �30'+_ � I 30"�I applied fm and hvther ac�rees to remove same upon <br /> `�� notice Irom the Cit <br /> y and to replace public property <br /> �d m ged �herebyO. �/ <br /> ��n4 C'_L�thG,f�(�_ �,,�.�.��.�. /.��..) <br /> S�ig7naawre of Applicant -���-� <br /> COPY Of iNIS API'LICATION TU �—� � � ���� �'�� [� 9� <br /> Address <br /> flE POSTFD ON JODSITE. y y� _�8�8 <br /> �:n!.1 f-NGiN[CItI�JGDENT. 25J�9811 � Te�lyaphoneNum/b�e/r — <br /> '�I Ilr�'.;i�, ff! lUHI CONSTRUCTION! / �� �—( -- <br /> Date � -- <br /> — / _ ni' <br /> CHECK LIST . <br /> Water Valve �. Fr,c ��%'"�`. �--�—� <br /> .�Z�, ��d�%� <br /> Drainage ; .' - / .� Dept. Approvals <br /> Curb & Gutir.r , �,� " ,; Engineers__ <br /> Sidewalk '� � � � ---_. <br /> ________ ._. <br /> - -. . .. � ,..j ', r cy� �/f Water------ -- -- -- <br /> � SVicet_..___.---.-- <br /> ..�nspeclur's Siynature "- - -�- Communications <br /> Tratf ic <br /> Planniny <br /> Date - _-__ _ . . _. .. . _ . _ —_----- -- <br /> _ -__.___— _.__. . . - __ <br /> Rr,marks _ .. _---�-- . <br /> Notc: Onyinal to Customcr <br /> , ��,,Y ,� F,�� 1 n 8 9 4 _ --- _ <br /> —_ _ - -- <br /> I Copy Io Inspector Approved by . <br /> __—_---._____._ .. _ .. <br /> Datc Approvcd .. .- <br />