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APPLICATI�N FOR RIGHT•OF•WAY USE PERMIT <br /> evcretl (-j 6 9 <br /> e <br /> CITY ENGINEERS � <br /> EVERETT, W/1SHINGTON PERMIT NO.__ <br /> The Undersigned �"� �� --� <br /> Hereby applies fur permission to `` f� � ?s /')S � �t D�i� - <br /> At Ihe lollowing location �//� �� '� � � �) ' <br /> � , , ..��� <br /> SKETCH <br /> (Work to be dnne) <br /> � <br /> ...__�.—.__.--- --- -- <br /> -----�--�-- -- --- � . �i <br /> ._ ---------- - ... I <br /> �� i <br /> � � �o' !:„.....i,� � � - ;�-�- <br /> '/ -- .� ! <br /> _ ..�.,_._ <br /> , � <br /> ; <br /> I i <br /> ., 3j- �, � �;, i , . <br /> ; ; � � , <br /> , �,,, � <br /> , . , � • ,r� <br /> - - ,; , , „ „ <br /> . . , ' <br /> �� <br /> �ii�� � ,,� , , ,�_ <br /> ,�. <br /> DHIVEWAY SECTION The undersigned owner hereby agrees to hold and <br /> NO SCALE save harmless the City of Fverett trom any anA all <br /> �.._ .._ . .____ — . .i claims fm damages that may arise because o(installa� <br /> 71 tion and maintenanr.e of the improvement hereto <br /> �� �I" LIP / I �pplied for and further agrecs to remove same upon <br /> �30•�. —T� �„30"� notice irom the CitV and to replace pu6lic property <br /> � damag dg Ihereby. � <br /> �.1� - � � a „ � -- <br /> ignature of Appl' ant l/ /_ _}j <br /> / � ✓/ 1 _�� i �// ` .' i / i // <br /> I COPY OF THIS APPUCnTIUN 7�) Acdress <br /> I BE POSTED ON JO[351i E. —'1'1-'` ` Tl � � <br /> Telephone Number <br /> 'I CALL ENGINEERING DEPT.259I;,�i ; _____ <br /> ��. ?J I{fllil�; Nf1UHi r:l)IJS1f+Ili�il�i,"i <br /> Date <br /> CHECK LIST Fee <br /> Water Vulve Dept. ApproV815 <br /> Orainage . . "�.� � <br /> Curb&Gutter Enqineers__�!_:_. ___._�.--.--- --- ---- <br /> --- <br /> Sidewalk Watcr . „ ; , . . '. . , . ._ . . �'..�. <br /> ___. . ._ . . .; l .� Street_y_.e�, .; „�M� . <br /> Communiwtions <br /> Inspector's Si9nature Trai�ic <br /> Planning. _ � <br /> � :. . ,..� •[ .g, j.,f. /��. t y , <br /> Uair _.�� �-7 <br /> r--� <br /> .. _ � _ __. __ <br /> Remarks � __._ <br /> Note: Onginal to Customer 10�6 9 - - <br /> 1 CopV Io File App�oved 6y <br /> 1 CoPy �o Inspectoi _ <br /> .. .. ___.. _.___ _ .. _. . _ _ . <br /> Dalc APp�oved <br />