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everen <br />e <br />CITY ENGINEERS <br />EVERETT,WASHINGTON <br />< <br />APPLICATION FOR RIGHT-OF•WAY USE PERMIT <br />1Q470 �� <br />� � �� <br />7 <br />PERMIT N0._ -" ' ! ` <br />The Undersigned Cc%�F �� ^ i � �� — L � � cf .� �. R/� r /C. O u/. r � <br />Herebyappliesforpermissionto—c�ns1��.�i 7Z"' cf,�;n 1:.,/ �r.,rG. <br />At the following <br />(Work to � ��oo) _ <br />I <br />� <br />I <br />r <br />. <br />m <br />� <br />a <br />�I <br />4 <br />� <br />ro <br />a. <br />— � — <br />s <br />/a v e <br />% <br />DRIVEWAY SECTION <br />NO SCALE <br />� --��7 <br />� I" LIP / � <br />�30'� __�30" <br />COPY OF THIS APPLICATION TO <br />BE POSTED ON J08SITE. <br />CALI [NGIN[EfiINGDEPT.259�8811 <br />. �i II[i�'�t'1 I;LI UH[ CONSTRUCTION <br />CHECK LIST <br />Water Valve <br />Drainage <br />Curb & Gutter <br />Sidewalk <br />Inspector'sSignature � <br />No Sccl� <br />�'.�' � �..�w <br />: �� i /76 <br />41�`>r> <br />�f�lXG.t'���.,,/C� -�/ <br />Remarks <br />Note: OriginaltoCustomer � 3 �%6 <br />�co�YtoF�ie 10470 <br />1 Copy to Inspector <br />. I <br />fcr 6�?ht distnnte <br />ti!5 over 42". <br />� <br />The undersigned owner hereby agrees to hold and <br />save harmless the City of Evere[t from any and all <br />claims tor damages that may arise because of instalia� <br />tion and maintenance of the improvement hereto <br />applied tor and further agrees to remove same upon <br />notiGe}from the City �nd to replace public property <br />.��=/o-�S� <br />Date '/ <br />Fee " �—�~-� <br />Approved by �� <br />i � ���L <br />Date Ap roved <br />