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everetl <br />� <br />�ITY ENGINEERS <br />EVERETT,WqSHINGTON <br />The Undersigned �J� �A <br />Hereby applies tor permission to <br />At the following locat <br />(Work to be done) <br />� <br />N <br />Na �Cq1E <br />APPLICATION FUR RIGHT-OF-WAY VSE PERMIT <br />I�ECMDN T D,E? <br />DRIVEWAY SEC710N <br />NO SC4LE <br />�-- - - -- � :i � '1 <br />��� LIP / <br />�30� _—'__�_�_/.:—_µ3� <br />,'�i ' �.�:�.t.iil <br />� E-NGWEFRINGDfPT.75!��',��'�,i <br />i ��'I' t�f'IRf ���i.l��lli�'. . <br />CHECf: LIST <br />Water Valve <br />Diainaye <br />Curh & Gut[e� <br />�idr.wilk <br />IJ <br />�. <br />,_ 1._ __.:-.. <br />Inspector'sSiynatur - -- <br />6a�e -- _ _ - <br />' ;,i <br />Remarks � , , , <br />Nnte: Original Io Customei <br />1 Copy to File <br />1 Copy to In;pector <br />0 <br />?EqMITNO. �� �/O <br />� -- �LH' J <br />''-� <br />i�� <br />-n�cw � �eNc�ErEl <br />DRIV[iN/�Y <br />cxi�Tiar si�r'w�x <br />cuRs � �urrE,es <br />II E I Thr undersi�ned owner hereby agrees to hold and <br />� save harmlzss the City of Evcrett from any and all <br />claims for damages that may arise because of ins�al;a <br />tion and maintenance of the improvcr;ent hereto <br />�PP���d and IurUier agree to rem��e :ame upon <br />noti 6o Ci d ta re lacc publlc prop ty <br />d a �, <br />� ; � - __ � '�.--�c%d� <br />,1 .�1 ,l g� T � icant <br />i <br />N �� �-/-��� <br />Adc r�� �__.---��_--�--`�-•� . <br />//�'�� ���, SC, / 8 <br />U` C �� � Telephone Number --- <br />I�� � oe�A 1�—.� : J� .-- -- <br />�! <br />� 1_�s�.-� � i�-i�-�y <br />Fee - <br />Dept. Approvels ���I <br />� <br />� _ <br />Enpineers� � !���' �7 a <br />Wa�er--����! / ' <br />SVeet_.��__1_��,.. . � <br />Traffic <br />�. � �, n p _ _ _ _ -=� ,. <br />App�oved h � i � ' <br />Da�AP � d C �J, /� -`---_. <br />' - %Y— <br />