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everetl <br />� <br />CITY ENGINEERS <br />EVERETT. WASHINGTON <br />The Undersigned _�;,,i <br />Hereby applies for permission ro <br />At [he fol�owing loca[ion <br />(Work to be dunel <br />APPLICNTION FOR RIGHT-OF-WAY USE PERPAIT <br />� v�� <br />_ CL F)R ARE/a , <br />� TD GfUN <br />42 3 742' <br />f�EVEP. L Y <br />�--- <br />�42 7 <br />,� <br />cOM�F���9 <br />'`'•U� � <br />. R`O GY <br />DRIVEWAY SECTION <br />NO SCALE <br />F- --- ---/ <br />i,� <br />i•3y . ___ . . . ._ 30" I <br />'1 <br />IfCOPY OF - � ,�S APPLICATION TO <br />I BE POdTED ON J06SITE. <br />� r_��L ENGINEERING DFPL 75�! �;t; �� � <br />� , ,�.���;� „F i ����..� , � � � <br />CHECK LIST <br />Water Valve <br />Draina�e i <br />Curb & Gutter <br />Sidewalkr <br />/ !: , ( <br />r � � _ <br />-------�L- — -- - - . _. . <br />Inspector's Si9nawre <br />— ------�--.. <br />ate <br />Notc: Original to Customer <br />, ����v �� F��� 1_ 01. 9 7 <br />1 Copy to Inspector <br />' W/DE <br />I�L VD. <br />10197 <br />�� -�/7 <br />PERMITNO._ J_ / �� <br />�C/ <br />Ni�TE: APPL1l/aA�T INlLL C��T <br />PERMIT FRDM P. U. D. F�R <br />ACCESS Tl1 /�Nt� FR�M <br />P.U.D R-C�-Inl <br />/7 RrF) TU F�E CL E,9RE D <br />�nD GR/1 DED <br />A�i � <br />.� NO .SC1aL E <br />��� �; i <br />The undcrsigned owner hereby agrees to hold and <br />save harmless the Ciry of Everett from any and all <br />claims (or dama9es ihat may arise because of installa� <br />�tion and maintenance of Ihe improvement here[o <br />applied for and t�rther a9recs to remove same upon <br />notice from the Ciry and to �eplace public prope�ry <br />damaged thereby. ' / <br />, ,r. t.,� %// �� ILc-�tiJV <br />SignaWrc 9f Applicant // �� <br /><� i� i �_ 5 c VJ-.r..c_ l, <br />Address ��� <br />7��23 BEVE,PL Y BL VU. <br />Telephone Num6er <br />_ 5-P-7S <br />Date n/ — <br />/Y� ���. <br />Fec <br />DGpt Approvals <br />Engineer5 /�-✓l��i�'r-l�lLr�C/ �/��/(- <br />Watcr ' <br />— <br />Shcet yi� i� ��/ <br />�`--- - }- <br />Communication� �-7l -��`-.--.�-�^ � _ -' S'- %� <br />TraHic__ � � <br />/ ' — <br />Planniiigl� - _Ci � <br />ApproLed yL _ <br />+�� ' /:=l.l� -c i C�f,_-'�� /. ---, �- <br />Daie Appioved <br />