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— APPLICATION FbR RIGHT-OF-WAY USE PERMIT <br /> e�eren <br /> e �0��2 <br /> CITY ENGINEERS <br /> EVERETT,WASHINGTON PERMIT N0. �I7� � y <br /> TheUndersigned1�✓/ l.� / _'1�,�.�/.il <br /> Here6y applies for permission to�cC��;„„_ i t "L S ��$i'r17!• i U/ C.i /!�i ;i�l- r a� ' <br /> At the tollowing location L 7� � ��l,J✓ <br /> SKETCH <br /> (Work ro be done� � <br /> i r <br /> `�r = /-�%i/�C'/'l��7 � <br /> DHrvEWAY SECTION The unAersigned awner hereby agrees to hold and �� <br /> � NO SCALE save harmless the City�f Everett from any and all <br /> -� � �---� - claims tor damages thet may erise becauee ot installa� <br /> �� ------- -� <br /> I �j���p� � tion and meintenance of Ihe improvement heretu <br /> ap lied�(or and further e rres to remove seme u on <br /> ��� �30'�_ . T_ _ . . . .�30" I 9 p � <br /> •� n tice Srom the City an place,qublic operty . <br /> � da d t ere6y. f/ <br /> U <br /> I Signat e of App�lic^ant � <br /> ' COPY OF THIS APPLICATIUN 70 Add es� /U r�� �U� � <br /> ��� I BE POSTGD ON JOBSITE. �. .'1 �S 7 ' 77dO <br /> Cr1LL I�NGINf[RWG f)EPL 259-BAl l � TeiaphoneNu�nt�er t/�7� <br /> � �// <br /> . 74 li(iURS R! FOFF ('[INSTRUCTION Date � <br /> CHECK U5T Fee 1 �--�� � � <br /> Wetar Velve Dept. A prov Is � <br /> Drainage <br /> Curb &Gutter Engineers � ,��..� <br /> Sidewelk <br /> — Water � <br /> Street�4�� � ' <br /> J-w..�-/_—_���.��_�_ <br /> --- —_ .._--------- - --- <br /> Communications <br /> Inspector's Signewre Traflic <br /> Planning _ <br /> i � <br /> - —_ __ _-- -— P !�(,.__���,b . <br /> �ete � -,r�� r-1 ,r�'- '1��_ac'� <br /> "_ —_ _- _.. ___'__-- .—_— <br /> Remarks <br /> Nore: Origii�al to Customer <br /> , coirvioFa� 1 � 77� <br /> 1 CopY to Insper.tor Approved by <br /> __.._—_--_ <br /> .____—.._. __—_—___ <br /> Date Approved <br />