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everctt <br />e <br />CITY ENGINEERS <br />EVERETT, WASHINGTON <br />APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />loassy � <br />� <br />PERMIT NO %/ - � /J <br />The UndersigneA J _., ., : � . �. � ��L-_ <br />f..��- � <br />Hereby applies for permission to i,� , r 1- -- —�_ <br />- _ _ .- .� �, _ d� ` -��z ��!'/75`%r�9LK <br />At the following location <br />(Work to be done) <br />( �i.-1ii�.)_,i �.,. .�i!-� <br />_ __ _--- � ' <br />_��_�3�_---� � _ <br />,`;:�i, /.a�'�. _'�� <br />,. <br />/ / ' � <br />DRIVEWAY SECTION <br />� NO SCALE <br />;`!�' � <br />— ----i----- <br />��ia �� <br />-.___.- �_J <br />�30.J� .._ . . . I 30" I <br />T `1 <br />� COPY OF IHIS APPt_ICATION 70 <br />f3E P��Tf D ON JO[3SITE. <br />�'. i� NGINFEqING DEPT. 259�R81 i <br />.":�a�', Ip 1(IHI 1'f1N';1R11(;7111'I <br />CHECK UST <br />Watnr Valve <br />Diainage <br />Curb & Gutler <br />�ewalk <br />�-�--��, <br />� ector'S Signature <br />- �j ._ '� /i"�„ <br />Dd(C <br />Remarks �� � - �-��-"- - <br />No�c: Onyinal to Customer <br />1 Copy to Flle <br />1 Copy to h�spector <br />l, ',t0/� COr�G _�w ._ . .. <br />�i <br />' S' � b "" r��;�A - " <br />P��rcel 'A.' -_' . <br />%��. f�..� ,/ <br />,1''•� <br />_� <br />Y <br />I'1� l � . <br />�' 4 <br />'��� } <br />' '� 13' � - <br />` •I <br />4 IW <br />�C � <br />The undr.rsigned owner hereby ag�ees to hold and <br />save harmless the City o( Everet[ from any and all <br />claims lor damages that may arise because of installa� <br />tion and maintenance of the improvement hcreto <br />�PP�'�d �°� and lunher agrees to remuve same upon <br />notice from Ihe City and to replace public property <br />damaged thereby. �. � <br />Signatur¢ of Appllca--- �i---'--'-----�-------- <br />�-" / � ) -�.. <� . <br />Address -____ <br />_�` ,,. _ ....r <br />Telephone Number ' �---- <br />Date - — ---... _. <br />-�,- -? , " li � -- � �s/-, � <br />Fee �---- C�.,�L <br />gP� pr v If � <br />i / <br />6igine r % F� <br />Watcr � �� <br />�l v_ .�:.-�� <br />str�ec� -���' / -� � . <br />�'�^�f---- __-_. <br />Communications-• Li�~ <br />Traffic +' <br />Plannir,g. '� : : / ' r . <br />_ � �� <br />•,<<, ,� v� -% ,_�C�(`� ��_ , <br />� n4R8 -- __ --- <br />` ' ._. ..__. _��'� <br />APProv �% � <br />____-•. - fi' <br />D:Ae Aj3jiioocd <br />