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APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br /> everen �O��� <br /> e - � <br /> CITY ENGINEERS 77� 2 � <br /> EVERETT,WASHINGTON PERMIT NO. <br /> �. The Undersigned %.::'.� .--J :' r 17..=.''/ � <br /> , Here6y applies tor permission to l� �S d..rc T a 's.? � �: '�!�!c � q/i/ - <br /> At the following Ixation ' ' �= F ' - — <br /> SKETCH <br /> (Work to be done) <br /> �7�E �,T�"�lc r�Ei� <br /> � I <br /> I i <br /> i <br /> � <br /> / � <br /> , � I <br /> � <br /> �` <br /> � <br /> DRIVEWAV SECTION The undersigned owner hereby agrees m hold and '�, <br /> i NO SCaLE save harmless the City of Everett from any and all �i <br /> � � <br />�i claims tor damages thai may arise because of installa� � <br />� r�- (I" LIP, tion and maintenance o(lhe improvement here[o <br />� applied tor and further agrees to remove same upon <br /> 1 30 __.f.3��..{ � notice trom [he City and to replace pub�ic property i <br /> i �I _ t'__�-. � <br /> damag hereby. I <br /> i �.,/.a...-... <br /> ig ature of Applicant � '��y,� <br /> �a V� U�' � <br /> �COPY OF TNIS�jPPLICA710N TO � AddrrSssti� �� i - <br /> � BE POSTED ON JO(3SITE. `� '3j I <br /> Telepbone Number � <br />' I �ALL ENGINEERINf DEPT.259-8617 <br /> I I l7: Ii0Ui3; BCFO(7� CONSTRUCTI6N: Date / /� <br /> i j � - - -- �- -- - - -- /�,�'V ,�l��id:. _ <br /> I CHECK LIST Fee <br /> i Water Valve Dept. Approvals <br /> Drainage <br /> Curb&Gutter Engineers � <br /> . C <br /> �� Sidewalk Wa[er� - � � � � - <br /> e <br /> _"£c ��crc Street��5' �.�y�/� .� S/G, >7 f.•.•.•� � <br /> i Communications ` i � <br /> I nspector's Signam re Traf f ic <br /> i <br /> i <br /> �. Planning � � <br /> i; i <br />, � ale _„_, : .-+i.����... .�..� � <br />` I <br /> I <br />� i Remarks 'i <br /> �i Note: Original to Cu:tomer + � I <br /> , 1 CopY to File �0 717 I � <br /> � 1 Copy to Inspector Approved hy � 'i <br /> k — i <br />, Date Approved ; <br /> 1 <br />