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APPLICATION FOR RIGHT•OF-WAY USE PERMIT ' <br /> ev�ren <br /> ��e so�32 <br /> CITYENGINEERS � <br /> EVERETT,WASHINGTON PERMIT N0. % -� '�. y ! <br /> TheUndersigned %'�`������ '�+�:�. / �' <br /> Hereby applies for permission to a J v; r ��a,' :r ��: �i:�r = n4_,,,-,..,� T - ,�; - _ ! �.a.n, � t II . <br /> i <br /> �, / L r,: : -' /' e��Y=rrrr�f� � . <br /> � At the following Iceation "'L<�✓ %�.�,;;�,.}✓ 4�✓,�y <br /> i <br /> SKETCH - <br /> I (Work to be done) ' <br /> � - , . -..i_.Nt/> <br /> I • <br /> i i <br /> � � <br /> I <br /> I ' <br /> I � <br /> I , <br /> \ <br /> { <br /> I � � <br /> I <br /> � <br /> � <br /> 1 I <br /> � <br /> � �� �� �— /D �i �/� � � , <br /> � <br /> i DRrvEwav SECT�ON The undersigned owner hereby agrees to hold and , <br /> NO SCALE save hartnless the Ci�y of Everett irom any and all <br /> �— � claims tor damages tt at may arise hecause of installa� <br /> I'� LIP tion and maintennnce oT the improvement hereto <br /> I I applied for and turther agrees to remove same upon <br /> --^i'30 30 notice from the Ciry and to rep�ace public property � <br /> —�------ � �-- --��{"--�1 �. <br /> damaged hereby. � , <br /> f' ��.;; ,/ � �1� <br /> SignatuM ot pplicaM . ���� <br /> a.1 i <br /> - � , I �,ii % ' ' � <br /> � COPY OF i�HIS APPLICATION TO � Address <br /> ' BEPOST[DONJ06SITE. ����•" ' <br /> '� � CALL ENGINCERING DEPT. 259-8871 ,I Telephone Number � <br /> Y— � ' / <br /> � �I 7-7 HOUftS 13[FOHE CONSTRUCiION� Date . , <br /> ------ - - - . �i . <br /> � CHECK LIST Fee � � � � <br /> Water Vaive Dept. Approvals <br /> Drainage ` f . -�,�,� �._ �.^^:,- ' <br /> Curb&Gutter s.� �� �'� � .*�: ./��-n ,. e�'.-,a -�� Engineers � ;" <br /> � Sidewalk �-, . ' .. ' . ' Water �. <br /> . ��!;�� ��. <br /> ,. Street <br /> Communications � �� <br /> , Inspectoi c Signature � <br /> Tratfic <br /> � Plamiing �� <br /> � ate <br /> Remarks <br /> '�, Note: Original to Customer <br /> i 1 Copy to File '� �1 C1�: � '�, <br /> �� 1 Copy ta Inspector �- Approved by � <br /> � <br /> Date Approved ' <br /> 1 <br /> � <br />