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.�� <br />_ ._.. . . � <br />cvcretl %+� i'LII;NI ION fOR RIGH7�-OF-1'JAY USE i'LRl,11 i <br />r ��� <br />L� <br />CITY EN:;INEERS <br />EVERET7,lVq5HINGTON <br />The Undersigned �� 1 S ��' �yJOU_ �( ��� <br />Hereby applies tor permission to GBi./ f7,f� v�'+� �r <br />At the (ollowing <br />(Work to �: done� <br />� <br />DRIVEWAY SECTION <br />NO SCALE <br />r-----T _ —� <br />�_ � LIP_____� <br />I-30�--- r------- .}.?�� <br />COPY OF THIS AP.�LICATION TD <br />BE POS7ED ON JOBSITE <br />CALL ENGINEcRING DEPT.2598611 <br />24 HOURS BEFOFtE CONSTRUCT70N <br />CHECK U5T <br />VJater Valve <br />Diainage <br />Curb & Gutter <br />Sidewalk <br />Inspector s Signature <br />Remark� <br />11154 <br />1:�154 <br />PI_RMITNO._I �.'—�� �-�— <br />� ` , <br />- � ,� � � �.. . <br />� . <br />_y <br />`?- � •. <br />�� <br />, �=- <br />The undursigned owner hereby agrees to hold and <br />save harmless the City of Everatt from any and all <br />claims tor dama9es that may arise because of installa- <br />tion and maintenance of the improvement hereto <br />applied for and further agrees to remove same upon <br />notice from the City and to replace public property <br />dama ed eby, / <br />�tN..o �! ��/ � <br />Sig�of P�can��—_`_� _- <br />i� � <br />Addres� � -- -- <br />�G7/E 3.s3 7�J 3 <br />Telephone Num e� <br />Date ,� a��� — <br />_i.�n ,'1i�l,i,'-,i:'. <br />Fee _- -`—" -- <br />Dept. Approvals <br />Enc�inecrs <br />Communications <br />Planning _ <br />Approved by <br />CU6TOMER Datcll��rnved <br />8 <br />