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- -. <br /> � <br /> everen APPLICATION FOR RIGHT-OF-WAY USE PERMIT ' <br /> � 10869 ' <br /> CITY ENGINEERS �/ ' <br /> EVERETT,WASHINGTON PERMITNO. �/��l� <br /> The Undersigned 1 i�/C=L��/ /�,:.. '��� � �� <br /> Hereby applies for permicsion to CGiv S r.0�.0 T /�-� '�S� C'O NC P ��" ��� / <br /> At the following Iceation 2 7 � � %I�DA1� WA�/ � <br /> SKETCN ' <br /> (Work to be done) <br /> SfE �l r>AC N = �� ' <br /> �, <br /> i <br /> 1 <br /> I <br />, <br /> I <br /> I <br /> ' DRrvEWAY SEC710N The undersigned owner hereby ar-ces to hold and <br /> � NO SCALE save harmless the City o( Everett trom any and all <br /> I '�, � � claims tor damages that may arise because oi installa� <br />� I i" LIP tion and maintenance of the improvement hereto <br /> i I 30, � I 30, applied tor and furthr.r agrr.es to remnve same upon <br /> � I�–��-- --�----�Y� notice frorr the Ciry and to replace public property <br /> dama eS1 er y. <br /> Signatur�( �p ican���-- <br /> � K T ', (�v�C � 9 % <br /> COPY OF THIS APFLicATION TO � Address � j 7Z <br /> � .� BE POSTED ON JORSITE. , _]���� �7 � <br /> � Te�hone��mxr <br /> . CPLI F_NGW[ERING UEPT. 259�P8;i � JV U Q 'cy �! /9 7`� <br /> - ' �� "���'R; I;FFpRECON;TI+UCiIpW� Date � � � <br /> � . CHECKLIST Fee /����Z— <br /> _ Water Va�ve De t. A <br /> Drainage P pproVals <br /> Curb&Gutter � <br /> Engineers � .i ��,�� <br /> Sidewalk _ Water <br />� Street <br /> _ Communications <br /> Inspector's Signature Traffic <br /> Planning <br />� at�e _ <br />��� �� � Remarks -- <br /> Note: Original to Customer <br /> , �o^yloF��e 10869 ' — <br /> 1 Copy to Inspector Approved by <br /> Datc Appioved <br />