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,____t" - APPUCATION FOR RIGNT•OF•l'VAY USE PCRNIT <br /> (cw�•�•rlt <br /> �',� ' 110]. 4 <br /> � <br /> CI7Y WGIWGERS <br /> CVCRLTT,WASHINGTON PGRMITNO. rll •��'-� <br /> Thn Undersipned /G.L ✓ HD y/��,{� <br /> Hercbyepplicslnrpermissi�ito�nti�7r�r�eT A ?����i��"v-r��=i'/,'��L� '/ nfU� rlYr,�,v��.u�,� <br /> Q••/ f1.��:�.16! ro..Tf/!� ''12�L'S/�,L1�..._P1J�«Q1i—:aY ' ' •;fh177/ ��L . <br /> At Ilie lolluwinp locetion /JD C, /�r/J_f�fy__ � <br /> SKETCH <br /> (Work to bn donel� ' <br /> 5F-c' /�-77"raC Ne"� <br /> O.f' �o Gc7�.fT�c�-�y' <br /> /� �(�yt1 f�Y�ct J ~�C�/i7l1 .T/d�t�.a../.� • <br /> /- <br /> �� �� ' <br /> DRIVEWAY SECTION . The undersigned owner hereby egrees to hold and <br /> NO SCALE teve harmless the City of Everett lrom any end all <br /> � --� � claims for damages that may arise because o1 instatla• <br /> p' L�p tlon and maintenance af the �mprovement hcreto <br /> pI 3 � I applicd 1or and lurthcr ngrecs to remova same upon <br /> I"`-`�1'� —►�30 notice from thc City end to replace public properry, � <br /> dama �tt�reby, y�y� � • �. <br /> . � ignature ol Appl� p <br /> 17�C (i��i�.r -T/ 71'n.e7S! L�/�� <br /> COPY OF THIS APPLICATION TO Address <br /> BE POSTED ON.�OBSITE. _,21) - � i 7I <br /> CALL ENGINEGRING DEPT.259 8811 TelePhono Numbcr <br /> �.-�s - � � <br /> 24 HOUHS BEfORE CONSTRUCTION Date <br /> CHECK LIST Fee �./u F6� � <br /> Wotor Val��e <br /> , Dept. proyals <br /> Orainage <br /> Curb&Guucr � Enpincen��� <br /> Sidewulk <br /> — Water <br /> St�oet <br /> Communicetions <br /> Inspector's Signatwe <br /> Traffic <br /> . . Plennlnp_,_ <br /> ate <br /> Ramerkt <br /> Note: Orlpinel to Customer - <br /> ,�o,,Y �o F��o 11014 ---- <br /> 1 Copy to h��peetor ApP�ovcd tiy <br /> Date Approved <br />