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APPLICATION FOR RIGHT-OF-WAY USE PERh71T 110 2 6 I <br /> %�I c.ri�•n �� <br /> �\, � <br /> �.b'F�� ' <br /> CITY ENGINEEilS PERMIT NO. �� J �" `� <br /> EVERETT,WASIiINGTON <br /> TheUndersigned �..,� y�o� S��Tf�— �9 ' <br /> Hercby opplies for permission to� � rt�G' � ��� {r�''4'�'T <br /> At the followinp location��f� ` '� � <br /> 1 <br /> SKETCH . <br />( (Work to be dane) � . <br /> S6L f}?`TR��f/� <br /> . , � <br /> • � <br /> I>i� �'o Goh r7'h�ic �' , <br /> . . <br /> `�7� �D��77 � <br /> I <br /> /; <br /> DRIVEWAY SECTION • The undertigned owner hereby egrecs to hold end <br /> N0.SULE� uve ham+less the Gty ot Everett from any and all <br /> � tlaims for damages that may arise beeause of installa• <br /> � . tion snd maintenance of the improvemen[hereto <br /> �I" LIP _ �, �pplied for and (urther agrees to nmove same upon <br /> i.,...i� �_70"_I � aotice from the City and ro reClace public PropertV f <br /> f"'�""f'— damae eby. � ��Td f <br /> � ��'.. ������' � � <br /> � Igr�aWr U�pp iCant � <br /> Z � 4�T�.� Qv� <br /> dress � d^ � <br /> COPY OF THIS APPLICATION TO ' „y� �� , rJv � <br /> BE POSTED ON JOFiSITE. tlephoJ'�N�'m,�be.r � <br /> CALLENGINEERINGDEPT.2598811 `t�'-�� ��4'� � � <br /> 24 HOURS B[FORE CONSTRUCTION <br /> Date "" ' i <br /> CHECK LIST � , Fee �� . j <br /> Water Valve' D@pt. pprovals � <br /> Drainagc . � • �'l r ' <br /> Cwb&Gulter , �npineers� i <br /> Sidewalk . . Water � <br /> SVeet <br /> � Communications <br /> Inspcetor's Sipn�ture � Traffic <br /> . . Pl�nning <br /> ate <br /> Remarks . <br /> Nole: Oripinal to Cus�omer 110 2 6 • <br /> 1 Copy to FJc qpproved hy <br /> 1 Copy lo Insp�clor � <br /> � D�u Approvcd <br /> � <br />