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everen . <br /> APPI.ICATION FOR RIGHT-OF-WAY USE PERMIT <br /> r . e � - 10�77 <br /> CITY ENGINEERS ,f ' <br /> I EVERETT,WASHINGTON ` PERMITNO. � T 2��7- <br />! The Undersigned i� �. I r`" , <br /> Herebyappliesforpermissionto " � � � ;>/. ., ; --i. � <br /> l ; � <br /> l � ' � ' � -f / i � ' <br /> r -� I <br /> At the following location . <br /> � . ,. y <br /> � <br /> SKETCH � <br /> . iWork to be done) <br /> i � � � � � . � , ' .. ; <br /> I —--- � <br />, I l. �.�_.__ "-1.____" . ' . <br /> � �1 .l �� � �' ��. <br /> I - .�.__ _� � . �� .1 v � li <br />� i.: 1. � I <br /> '� � < �l- ! ' , <br /> ; + + � <br /> � I ' - ; - - _ ' ' <br />, I I� I _—�� ' . � ,, I ,, i <br /> ' \� + ' I � , , I � � ° 4 <br /> i � I � ... ' . , ,,,� ; .~, � f , <br /> J ';, I �, <br /> � , I � ' I i: _ � �... ..i,., .y � ; j <br /> ; i � �� � <br /> � a � II - `. <br /> -_==- — -- -_-- , _� _ <br /> , � <br /> � <br />_ ; , <br /> , � ; <br /> a <br />� � _ . � ; <br />� � <br />� . DRNEWAY SEC710N Tite undersigned owner hereby agrees to ho�d and �. <br /> '�. NO SCALE save harmless the City of Everett from any and all � <br /> �', � �� claims tor damages that may arise because of installa• � <br />- I �� �i^ �ip tion and maimenance of the improvement hereto <br /> applied tor and further agrees to remove same upon � <br /> ' 30" _ _I_30" notice irom th,e City and to replace pubiic property <br /> � demaged fTlercil'y, �� :-� � <br /> j �� //ILr. ...I� �. � Ji,�r¢ .. . �. <br /> �. Signature oi Apphcant l�' � � <br /> i � i ,;� -,-�,0,,:»� _ - ,;/ ' <br /> . ' COPY OF THIS APPLICP.TION TO Address • . <br /> 4,; ' BE POSTED ON JOBSITE. � . - � _�- "` �/ ;� <br /> �� Tele hone Number � <br /> . � CALL [NGINEERING DEPT. 259�IIII17 � P <br />�,� . . / _. , - ':7 <br />�. . �� �4�IIOURS RE-FORF CONSTRUCTION� Date � <br /> CHECK LIST Fee �. <br /> � Water Valve Dept. AppfoVals <br /> Drainage <br /> Curb&Gutter Engineers � '�'� � �� ' <br /> Sidewalk <br /> I Wa[er <br /> Street <br /> j ��� � ������ ' ��'����' �-��"" � . Communications <br /> Inspector's5ignature � Traffic <br /> � � / i <br /> / �' . <br /> . . <br /> i.,� Planning <br /> '� �ate " � ` ' � <br /> Remarks <br /> Note: Original to Customer <br /> � 1CopytoFile �0(177 �. <br /> 1 Copy to Inspector Approved by � <br />' � Date Approved <br />