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APPLICATION FOR RIGHT-OF•WAY USE PERMIT <br /> evcrett 1�'l 7 g <br /> e <br /> CITY ENGINEERS � . , <br /> EVERETT,WASHINGTON PERMITNO.___ ,(__.______ <br /> The Undersigned r� __ �'�� � " ' � — � <br /> Hereby applies tor permission ta 1'� +� � it � ��� C�-- � �,?� ' � - " r'`=� ��" � '%�L— <br /> � i <br /> At the following location )/// ._' N S J �v i� 7:�� �f ,�r :, ' � • / �7J �:, r'4'-�� �f =� <br /> SKETCH <br /> �Work ro be done) <br /> 'r, . � � r' = � <br /> ' �' A Q:>J�J 1� J r� U <br /> ; � ' J ' <br /> ;-r-,_ � � , ,_� yl -- t- : lli. � . , f,_ „ <br /> I, F' +, � - N`: <br /> I r F vi.. F:i /, .,r ������ � /� <br /> a <br /> Q ��/ �6/�rh:'J �.�. � C : <br /> � ' <br /> ��� -----._ �.� St.i//i� ,_ n ,� t' / �;--� <br /> / r. i . / <br /> �/l/ h/'ri/Ir Z d • �` <br /> ` " ��.,� ,Pv_I . i F � , . <br /> �O v � � (A'_---- f� 1 <br /> `T n I- <br /> I � I <br /> � � � <br /> �- _ � ------- _ _. <br /> � i; ,r - , r . , l� i� '� <br /> DRIVEWAY SECiION The undersigned owner hereby agrees to hold and <br /> NJ SCALE save ha�mless the Ciry of Everett from any and all <br /> - - - - - +1 claims lor damages ihat may arise because of installa� . <br /> � <br /> tion and maintenance of the imp ent hereto <br /> �—L��P—_� applieA for a lurlher agrees to r ov same upon <br /> r30�� � I 30"� notice Ir e itY and lq..teplace lic propeny <br /> � // \ <br /> �m a — � I _ �- <br /> �GC/' '��% Q�'f� <br /> , Signature of A 'cant <br /> IL <br /> corv oF rHisnvrucmwr� ic� nd��?S =— �S—`%f�� <br /> , I;E "n;T(:� ON.IOfiS�T-L TelephoneNumber �j <br /> Cn;_L � �:�iIN! I I+�'iG DEPL 25J �;� - '� '20 �7/ . <br /> ?,t n��u�C�, I�i Inl.l r�iNsiRu�.ii r. Date <br /> . /�./ - I 1<�_.�-- -- <br /> CHECK LIST Fee <br /> wa�er vaive Dept. Approvals <br /> Dreinage �� • " �� , <br /> Curb&Gutte� Engineers_ ��('�--_. <br /> Sidewalk ,)-� ��� � - �Wate� r' � � � - <br /> ; <br /> ----__ .._ .�—'. ; , /, l:�c� '���=�,�, ., <br /> Street � ` ' !' --,_ _ <br /> -----�-�--�-=•----'- <br /> Communicatians _ <br /> Irspector'sSigna�urc � Traffic_ __ _. <br /> Planning ---- <br /> — _ __ � ,�—�!� � <br /> -�a�� °�`� - <br /> _ __ <br /> Remarks <br /> Nole: Onyinal tu Cus�omer <br /> , ���,Y �o F��� 1�;7 8 __ <br /> 1 Cupy to Inspecinr ApprovFd b� ,. - <br /> 11---._,,. . _ <br /> ____...__ ...._ __.__ . __ .___—_ <br /> D.te Appraved <br />