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,._� _---�- - - — _ <br /> � <br /> P^DLICATION FOR RIGHT•OF-WAY US� 'ERMIT Z1125 <br /> , � everen <br /> � <br /> CITY ENGINEERS " - <br /> EVEREtt,WASHINGTON PERMIT N0. 78 '�3 9 <br /> The Undersigned f}��J S/LFtE�? _ <br /> Herebyapplietforpertnission ;oCo.�s7'?vcT' A FBiJcL �Q�Y. 4� /�iCM Run �����+(eX 30� �ont <br /> .�rLuy�l.tr' fns7 � w£s�f �..� c��ry Pani' <br /> r <br /> Atthefollowingloeation��OY �i��ApWR ✓ � <br /> J � <br /> SKETCH <br /> (Work to be done) . <br /> �� _ <br /> -i � � . <br /> � <br /> � .. <br /> �� � � I <br /> . j <br /> , � . � <br /> � <br /> � � - F <br /> DRrvEwav SECTiON The undersigned owner hereby agrees to hold and � <br /> NO SCaLE cave harmless the City of Everett from any and all <br /> r---- —�---� claims tor damages that may arise because of installa� <br /> `�.. ��P —�1 tion and maintenance of the improvement hereto <br /> . <br /> applied for and luriher agrees to remove same upon <br /> �0'.�+-_�----�- .-- .-.-__.+.30" nmice from the City and to replace public properry <br /> dam�phgd thereby. / / <br /> �i�Y�<_�[.��/ rl�� �-�:s!�_. <br /> Signature of ApplicanA � <br /> �i��n Y �i7.2�arCcc��c. <br /> COPY OF THIS APPUCATION TO Addry�i � ,J� <br /> < «-c< < zT ll- �. �(J e': o, <br /> BE POSTED ON JOBSITE. / <br /> Telenhone Number <br /> CALL ENGINEERINGDEPT. 259-8811 � ,;(,s' � - 7 y;.� � <br /> 2� HOURS BEFORE CONSTRUCTION Oate <br /> -- �2 -is-- 7 :Q <br /> CHECK LIST Fee <br /> Water valve Dept. Approvals <br /> Orainage <br /> Curb&Gutter Engineers <br /> Sidewalk ' <br /> Water <br /> Street <br /> Communiwtions <br /> Inspxtor'sSignature Traffic <br /> Planninp <br /> at�e <br /> ---- ,, <br /> Remarkti � �� �� <br /> � APPwved by I <br /> CUiTOMaR Date Approved � <br />