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evere7 <br /> � APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br /> e - so5�2 ; <br /> � <br /> CITY ENGINEERS �I , � <br /> EVERETT,WASHINGTON PERMITNO. / �� 5 � <br /> The Undersigned '� - ,r.' ( <br /> Hereby applies for permission to /'�.,c �.�-: f i�� ,_ , 9 .�cF,� . r/ � � /-,�n� � <br /> At the following location ��fy / Fi hrd lS.���d ,.✓,�, . <br /> � > > <br /> SKETCH <br /> i <br /> (Work to be done) . /� 3 Q� =i kr'E T' ' <br /> _ rto.,� k.s, t, b� � <br /> � a„ d scd pad <br /> /O' tn ¢ D „✓ <br /> -.�ro�st. Ns�h. n <br /> � --_ <br /> �` �; <br /> `' 1 <br /> �:' , <br /> � <br /> � , <br /> i I <br /> �� �0 : 1 / i <br /> �; <br /> i� -,' <br /> � ; � <br /> �// I, <br /> � ;,�:» te be LdnKa�/ I ' <br /> onst �S(�! � � <br /> � o I � <br /> I . M"� -'ll/ V �/ r I <br /> �. - i <br /> �Jdf Ev — <br /> — — i <br /> L EX in/�� Ton. ` <br /> � /sf ' ASPNALT l�MVLMCNj �� <br /> ��, DervEWar sEe7i0N _ _ � __ The undersigned owner hereby agrees to hoid and � <br /> {�NO SCALE save harmless the City ot Everett from any :�nd all <br /> � I - --'� claims tor damages that may arise because ot instaila� � <br /> � �^ ��p tion and maintenance of the improvement hereto '� <br /> � applied for and furtber agrees to remove same upon - <br /> I� 30' �— 30' I nolice from�,the Cib,• and to ieplace public property <br /> i I"��--- ��'I � � <br /> dam ged-tFiereby� � � � <br /> i <br /> �I i�i amre of Ap�licant <br /> ----- -- — -- _22 ^ - Or � � <br /> � COPY OF THIS APPLICATION TO r�ddress ' � � <br /> �' BE POSTE�ON JOBSITE. �7-l 5'7 � � <br /> - Telep one Number <br /> f.ALL ENGItJEERING DEPT. 253�9II71 � <br /> , �9�z� <br /> 24HOl.iI��51;CfORECONSTRUCTION� Dat ,�, „ <br /> ' '� "� �U i, q n.,�{ . � <br /> i. CHECK LIST Fee - ' <br /> Wacer vaive Dept. Approvals <br /> Drainage <br /> C:urb&Guiter Engineers <br /> Sidewalk <br /> Waterl �• e�' ear-sC�c / f�'. <br /> ! Stree[��� _�' <br /> � <br /> � Communications ' ' <br /> ��. Inspectoi s Signature Trattic <br />' Plannic9 � <br />' <br /> �;� — Jc�e�. � d s.o �f.3 <br /> Remarks <br /> � <br />� � Nore: Original to Customer <br />, , �oPv ta F��� 1(15 8 2 �i-�� „ <br /> 1 Conv fn Incnnr(nr Gnnrn.�nd M ` � i <br /> .. �---- � -'I f�- � �17 � � <br /> — - r;— -- <br /> Date�Aphroved � ' <br />