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rw � i�tl� � <br />.-J <br />��� <br />CI'fY EMGINEERS <br />EVERET�f, 1YASIiItJGTON <br />APPUCATION FOR RIGHT•OF-WAY USE PEF;rv11T <br />11019 <br />PE�MITNO. ���� ._ <br />TheUndcrsigned�_ MELUm��EI� Sh7/� __ <br />Herebyapplics+orpermissionio �9IV<Y2Uc7� f1 ^�-}�� r}S�.Ytj-!7'� n/i,i __ <br />.�.-�r,.��_ <br />A[ the tollowing location_�� D �{I� �7�r C _ _ <br />SKETCH <br />(Work to bc done� <br />5EE A7TACHED <br />l_%� �D s"n1�S �/ec_�7 <br />jGL�j // <br />J <br />ORIVEWAY SECTION <br />NO SCALE <br />�`---- ----� <br />— I° lIP �l <br />30'�_ �30',J <br />–t <br />CO!'Y OF THIS �PPLICATION TO <br />BE POSTED ON JOBSITE. <br />CALL ENGWCERING DEPT. �59�6871 <br />24 HOURS [1F�ORE CONSTRUCTION <br />CHGCK U5T <br />Wator Valve <br />Draina9c <br />Cur6 & Guner <br />Sidewalk <br />Inspector's Signamre � <br />R!marks <br />Note: Originnl tn Custnmrr <br />1 Capy u� Filr 11019 <br />1 Copy to Irupeclor <br />Thc underfigned owner hereby agree: to hold and <br />save harmless Ihc City of Evere[t from any and all <br />elaims for damages tliat may arise 6eeause of installa� <br />tion and maintenance of the improvement hereto <br />appiieA for and furtFier agrees to remove same upon <br />notice from tlie i.ity and to replace public property <br />da �ed there��� � '7 . <br />' Y G�nrc <br />t+�l � .�j�li l.,•t. �� <br />Sig {ure o1�ApplicanL <br />�-u�� � �� <br />Address <br />__3_� r �f � 3 y <br />Tclep nc Numbcr ^, � �7 <br />.n •3 � <br />Date � <br />A2 5fl <br />Fee <br />Dept. Approvals <br />En9ineers_ _ <br />Commun <br />Tral(ie <br />Approved by <br />Uale Approved <br />