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% <br /> ,�,�� APPL'�TION FOR RIGHT�OF l'JAY US[ PEP'11T <br /> �_:� -- � ., .. _ , <br /> �J <br /> CITY ENGINEGRS <br /> EVERETf, WASHiNGTON PER�AIT NO. �� : � �' __ <br /> TheUndcrs�gned Roh/rat.6 T/oGTas./ � <br /> Hereby tpplics for permission to ('ONSTA'��c T 2 - y� �/�n iVC.C�=1c /��i ' <br /> At the following location�3� z!- (SE��R p ��7 i y Dgi i C /�✓'",� <br /> SKETCH <br /> (Wo�k to bc done) <br /> S�c RT7'AcN�o <br /> 1J,C� fo Ca�s t'h�� ' <br /> � � . <br /> �`T/ <br /> I <br /> DRrvEWAv SECTiON The under�igned owner hereby agrees io hold and <br /> � s��E pve hertnlest the City ot Everett from any and all <br /> � elsimt for damages that may arise because of insta'la� <br /> I" �Ia __� tlon and maintenance of Ihe improvement hereto <br /> LDO"I—� jp�� �pplied lor and lurther agrees to remove same upon <br /> r— � , notice Irom the Ciry and to replace public properry <br /> d ed thereby. �{ / <br /> � �a.Vc.Q CJ.�)H�a.. <br /> . $iB��ure ol Applicant — <br /> �Q�Q Lic Karwr :-� �'o S.E, <br /> COPY OF THIS APPLICATION TO Addres� l <br /> BE POSTED ON JOBSITE. 'Z55 - '7Q/(o <br /> CALL ENGINEERING DEPT.25�J�BB11 �elephone Number <br /> `<<c.� 2z, �27'1 <br /> 24 HOURS DEfORE CONSTRUCTION Oate <br /> CHECK IIST �So= <br /> Water Valve Fee <br /> Draina9e Dept. ApprOvalS <br /> Curb&Guucr Enpincers <br /> Sidewnik <br /> Water_ <br /> Street___ <br /> Commimicatinns <br /> InSP�[lor'S$ipnaluic -- — /. � . ; i . , <br /> Trallic1 ' �` 1 ` . <br /> Planning_ , --- <br /> -Datc -- — <br /> Rem,nks- --- — _ � <br /> Nnlr: (lnryinJl In f.u�.lninr/ I <br /> � (�i�l'Y In I Jr � I I � ' � '1 ____ _ __'_ -_.".'____ _ . � <br /> 1 C�q�y 1.� In�l���� Iu� A�qnun�iby . <br /> Udlr A��pinvrJ ' ___'_. __-" ; <br />