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APPLICATION FOR RIGNT-6F-WAY USE PERMIT <br /> �°� 1089 ? <br /> CITY ENGINEERS -- <br /> EVERETf,WASHINGTON PERMIT �JO. � %" ,' %�' <br /> The Undersigned l. ,�_.,,.i 1 ��,i l. , �c � (_, + � _- ---- <br /> � ,, <br /> Herebyappliesforpemiissionto �:i�/GT_''� ' i� .' i i-���.�_L <br /> Atthefollowinglocation_���� d � �%�'���-�'� i - <br /> SKETCH <br /> (Work to be done) <br /> ; �� �� ��1���T�1 �. „ �_ ��� <br /> DRIVEWAY SECTION The undersigned owner hereby agrees[o hold and <br /> 40 SCaLE savr. ham:less the Ciry o(Everett irom any and all <br /> r---- � -- -- - - � - � cla�ms foi damages Ihat may arise because oi installa� <br /> --�� tinn end maintenance of the improvement hereto <br /> �� ��I" LIP applied for and turther ac�rees to remove same upon � <br /> �30'��-. ._�.3Q�� notice irom the Ciry and to replace public properry <br /> damaged thereby �J <br /> �i�c4� 4 �°/l-�,�/ �� �'�__���q�� <br /> S� natwe of Applicant <br /> �U/'1 a chyJ:, �(� � (��. <br /> corv or riiis nc��ucn�ioN tc� A�`y.3 _ OB F- S <br /> BC- POSTED O�J JO[351TE. <br /> ' Tele hone umber <br /> CALI. ENGINfERINGD[PT. 7!i91!E11 <br /> / ��.—_..—.— <br /> :'41i(���li:� P.I PUII(. LUNSIRUCII�K. Dat ,� -� �„U � <br /> /1 <br /> CHECK LIST . Fee �'� {�f/�7 <br /> Water Valve . DBpt. ApproV815 <br /> Draina9e � � <br /> Curb& Gutter )�i�� �� En�ineers ._ <br /> Sidewalk � I � �, iG 'r ; Watei ._.. _ <br /> —.—__- __. . j <br /> - , „Y�� Street---- .._. .------`---- <br /> ' Communicu�ions <br /> Insper.tor's SignaWre T.affic <br /> Planning <br /> _ . _ .__ _ - �-- --� � <br /> 6a�c <br /> Remarks------ -------- — <br /> Note: Origmal to Customer <br /> 1 CoUl to Fde � r (� � ? �---- — ------ <br /> I Cupy �o Insp��r.Ini - - ApProved by <br /> _—_—_ . _.. . . . . _ . . <br /> Date APProved <br />