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APPLICATION FOR RIGHT-OF•WAY USE PERMIT <br /> evcrctl <br /> e . 10542 <br /> E EqENGIWASfiINGTON PERMITNO._ �� <br /> Th^ Undcrsigned_______,_ __ _ _ _ � <br /> Hereb��applies lor permis�ion to f� P !'f =r c -�r lr� �GC � i� ,�„t� � � i� ,il,�y � <br /> -----� S 1 ` � �'_� „ c ; f�w <br /> Atihefollowingloca[ion N . w_ f�„- qc.. � /� �o/ h ., c.-,.1 ('/. / ��n � .�.ti n�___ <br /> sho,��n h ., � h �a�rl crFc.. (_��/� �--- �%• -1 s2i <br /> SKETCH --. . .-- -- ---� � <br /> (Work [o be done) '� <br /> � � <br /> I <br /> }. �I F, ` � <br /> m � � 'j <br /> U ` � � <br /> V I <br /> V <br /> i � � � r� <br /> II - <br /> c � <br /> « � <br /> � Q <br /> / � ��� � I <br /> - T--- - - ---- (� � ��.-�,�eol .,�o,� rn bc. I <br /> I I <br /> �V _.{� % , ..r,��:.,: / l;H 3[riil�il.� <br /> ✓ <br /> �__ -f--=. -_'__ rf�L T . L. ----- <br /> -r� � c.,:t�,�,����..,� r � <br /> _L � I --TI i <br /> I <br /> �-` " j <br /> � A111-0hfv1A � � <br /> �- 1�4 ' <br /> i <br /> P��, _ „ I� <br /> �.4J ��S�](� <br /> DRWEWAY SECTION The undersigned owner hereby agrees to hold and <br /> NO SCALE save harmless the Ciry of EvereU trom any and zll <br /> �- --�- --- -- - �`{ claims for dama�es that may arise because of installa� <br /> _�I' LIP �� tion and main[enance of the improvement hereto <br /> _ ' applied tor and lurt agrees to rerr'ove same upon <br /> �30'�-� _�30"� notice t��mlLte Ci� nd to repl o- aublic property <br /> ... .__. dam�d � e�qby. ---.. <br /> 4 � <br /> Signatu of Applicant <br /> -'--_�:1�� �u S�_ <br /> � COPYOFTHI:;APPLICl�1�UN In Address� � <br /> i • �-r, s <br /> � RE POSTCD ON JOBSI7 L G- -• � - '/ I '7 I <br /> Telephone Number <br /> ��.l�Ll CWGINC.LHINGU[P1�. 259�HH1 � <br /> I�lflO�I1;; R[FOHf Cf)6P.� IqU('l�� i:d Date - �"- <br /> CHECK I.IST Fee � <br /> wa�e�vawe Dept. /�ppro��als <br /> Dramage � . [ <br /> Curb &Gut[ei [nyineers._�_�_ _�(` �� ______ <br /> Sidewalk Water <br /> ^treet�._�, _.,,:_ _—_ <br /> __ __________ Cammunicatio s,_ <br /> Inspector'sSignature � Tiuffic � ' . <br /> Plxnning� ..L '��.- � �i (r �. <br /> -�ate--- - � - - � -- :. <br /> Rema�ks .____ . .- . . , <br /> Note� Gn,mal to C�istomcr - - <br /> , .�„Y ,�, F,��, 1 n 5 a 2 -�,--�---- - <br /> 1 Capy lo InsP^cior Apprbved by _ (� 1 � � <br /> < Fjra,w�..� —�i _ <br /> Datr. Approved � <br /> � <br /> � <br />