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,i , <br /> AP CATION FOR RIGHT-OF-WAY USE P'9M1T I <br /> ev� <br /> 10912 <br /> CITV ENGINEERS <br /> EVERETT,WASHINGTON PERMIT NO. � ��3 a v I <br /> i <br /> The Undersigned��'.a � J r��L T✓�i <br /> Herebyeppliesforpermissionto �"�LN�Ti2✓� "r 2 - �i �� '.�.u','.'r�- /�/,,, �< <br /> At th•following location 3 � �- c' C r,�A.? �3 7/ � ���3� ,p•c d,. - 1 - -- <br /> SKETCH <br /> (Work to be done) <br /> Sic AfsAcN=,� <br /> I � <br /> � � <br /> i <br /> i <br /> � <br /> I <br /> I <br /> ORIVEWAY SECTION The undeniened owner hereby aprees to hold end I� <br /> I NO SCALE save harmless the City of Everett from any end all , <br /> I'--- -- � claims(or demages thet mey e�ise beceuse ot instella� �. <br /> �I" LIP tion and maintenance ot the improvement hereto , <br /> -- , applied far and further agrees to remove same upon <br /> �JO_'�-. , .___�30' I notice from theCiry end ta replace public property ' <br /> .� <br /> da ed thereby. �� <br /> .�`."�,_,,.s�' � �7���� . � <br /> , Signa ure of Applicant � <br /> �,.qvzo Lk K,�TN� E-,,i k'o cSE. <br /> COPY OF THIS�PPLICt1TION TO '� Address �, t,�d✓i1 ' �!p SS <br /> ! BE POSTED ON JOBSITE. '� 255 - '7l�/Co <br /> C A L L f�N G I N E F ri I N G 0[P i. 759-Uli 1 I Telephone Number <br /> � ' �'7� �_��Z% 7 , <br /> � � 7411(lUHSRf-�U({! (1IN51RUCTl(7N�1 Dete � rJ/A�� '� <br /> 1S _�7 <br /> CHECK LIST Fee <br />� Waror Valve � <br /> Drainage UBpt. AppfoVels <br /> �7 f ' <br /> Curb&Gutter Engineers 7__�/� � /�__.___�____•-o.__-__ <br /> , Sidewalk Weter <br /> Street <br /> ' __ ____ Communicetions, _ <br /> Inspectors Signature <br /> Treffic <br /> � Planning � <br /> UtlM <br /> � <br />� Reinarks — — <br /> Nate: Original to Customer — — <br /> 1 Copy to File � �9� 2 - - � <br /> 1 Copy to Inspector Approvad by <br /> Date Appraved <br />