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' APPL!GAT!nN �nR RiGHT-OF•WqY US� PERMIT
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<br /> CITY ENGINEERS '"' '
<br /> EVERETT,WASH'NGTON PERM�TNO. �''� '�� '.
<br /> TheUndersigned - '�:� ✓i,H � .t� �. V.��'—'C �•-�� -.�'r�C_-G=c:�J Gr= : ;cr�:.?�J ��,
<br /> Hereby applies for pertnission to���L �i'�%C uC � ' � ',C-'r,'� �' I
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<br /> At ti•e following iocation � � ? ��
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<br /> � DRIVEWAV SECTION �'he undersigned owner hereby agrees to hold and
<br /> �I �t�0 SCALE save harmless the City of Everett irom any and all ,
<br /> � r--- ----—"� ciaims for damages that may arise because of installa• .
<br /> � i„ UP- �F� tion and maintenance ot the improvement hereto
<br /> applied fur and further agrees to remove same upon
<br /> I �0�}.—- ----�.3� � notice irom die City and to replace pu6iic property ��
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<br />� ! / Signature oi App'licant �
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<br />, COPY OF THIS APPLICATION TO '' Address ` � .
<br /> 8E POSTED ON J08SITE. � Z � Z ' 7 z-7Z
<br /> rqi_L [NGINEERINGDEPT. 259-SRt1l 1 TelephoneNumber
<br /> i � - //� 710
<br /> ni �. �.n - Date . � .
<br /> � 7�I H_ . RS i�,�-t HC CONSTRUCTION� , ;
<br /> _ _ . -- - 4i;;;� -; .t, � _
<br />. � CHECK LIST Fee � ,�
<br /> ' Water Valve �
<br /> t ro IS �
<br />� ����. Orainage �/��I—��2/� �
<br /> �� Curb&Gutter Engine s �< <�� � u i
<br /> • Sidewalk Water 19c� l�u_i.der/�!�enrsc<r�� '; �• !?
<br /> , -x�r+id"'t'��AMk- '7�Street �,.r__, %
<br /> I! 3��~ Communi ions � I
<br /> Inspecror's Signature � Trafiic � i fc��
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<br /> �`; ;� . .. � � / Planning `'�
<br /> I �ate ,Ftyr�•. �. � �o L.,4 �-6'D',
<br />� Remarks
<br /> ' Note: Original to Customer
<br /> !� 1CopVtoFile ��362 / —
<br /> 1 Copy to Inspector Approv � �j � r ��
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<br /> Date pproved
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