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everett APP���ATION FOR RIGHT�QF-WAY USE PERMIT <br /> soaoc���� <br /> e �,�� <br /> CITYENGINEERS ��: � <br /> EVERETT,WASHINGTON PERMITNO. '� �--� // <br /> The llndersigned _�'�"�==-�--�__��- � �!�r _ <br /> HerebV aPP��es for Pe�mission ro �' ilr ��` r_..f-/I-.��.'/�_t:- � :1-' ,�. L�� <br /> Atthetollowinglxation i����= �C� r"• ��"LL r�.-+C- L� � c:'��� 's� C __ <br /> / / _ <br /> ii• � �.�-�iAJ <br /> SKETCH <br /> (Work to be done) <br /> ry ��'�l �; % -�i;� ��J�30 <br /> - - , -------------- ---- . --- -- - - <br /> � <br /> , y�l�/� <br /> ,, � l�L <br /> .�� , . <br /> z�, . �/��i� <br /> �,,,- - � �_� , <br /> 1 �Y I � <br /> �; �,�r��� � <br /> �, � , , . v,;-s <br /> � � j�+ �l�� <br /> ��.��ST _-<.;�; .� <br /> i �� l <br /> LiNK =E�"�''F <br /> ,. _-- - ' K�l'V 'i .�''� `,c;-� ..�:� I <br /> - /�. �`I!;� -����.� . .. . . <br /> �'4 <br /> n ; ,. <br /> ti ; � �t � <br /> 4 ^ �. <br /> �I � � <br /> DRIVEWaY SECT10� The unde�signed ownr.r hereby agrees to hold nnd <br /> NO�SCA}� i saer.harmles�. the City of Everett irom any and atl <br /> �-- � -- — �[� - � �� V claims`or dama9es thet may arise because of installa- <br /> �-- � ' � tion and mei�tenence of the improvement hereto <br /> �_�Y' LiP �� ���,/� µ ;� �pplied for a�d iw ther eprees�o remnve same upan <br /> �.30':'.- T- �}.30".� `'v �/ notice from the^ity nnd 10-r ubhc pioperry <br /> 1 <br /> l.'� �(,, damr ed h � � , <br /> .�, IG' — ��%�Y� � �__ <br /> , <br /> iJ � Signaturc of Appli nt <br /> 7.,r> 7� C.JL7�f;,.tr� -L- ✓C,'lE1�r <br /> i.�iPY OF THIS .4PPLICFlTION lU Address� ` . � ��� p <br /> ��.! POST[D ON J7f?SITE. -.t-�I�GL`3 -.- _ <br /> Telephone Numbet <br /> � , �� I I r.l���rll 1 IiIIN: I��f I'T. °5Ui" i �. <br /> �''ii/�.:�.�� I�' --�—_— <br /> . � �n �i�i�'. iflci�l .��. r�1;IRui� i �� r; Date <br /> -�, .. <br /> _ — —�_—._--� ____—_"__ '— <br /> CHECK UST Fee / <br /> Water Velve IID S / <br /> D�amage T � , /, _ /6 <br /> Curb &Guttcr Enginet s ,(/��// <br /> Sidewalk Water ` �.��rr SC�+ P � 'g� <br /> --- - Street—�14.�=:.:J..... --. - --.- <br /> Communicatio s <br /> - - —-- <br /> Inspectur's Siqneturn � <br /> ^ i;. , . T.affic_ . <br /> -- <br /> 1 Planning ( � / /7���7 <br /> -- -- - . . . - -- - - Sewer ���.1���' Jd+. �.�,p <br /> Uatc �- --- � � v✓. <br /> —.—_._____ _ . .__.. __ _ - _._ <br /> Remarks <br /> Note: Original to Customer <br /> , co,,Y �oF�ie 1 (1 � n6 <br /> 1 Copy ta Insoector ApP�oved by' . 3� <br /> -1 <br /> Oate Approved <br />