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APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br /> rverett :0123 � <br /> � <br /> CITY ENGINEERS ��— 9 <br /> EVERETT,WASHINGTON PERMIT N0. <br /> The Undersigned QL H60E <br /> Hereby applies tor pertnission to LANDSCIII�E L,`' REP/�/R .'�9MAG/_=D S/laCWALK — : <br /> GOi1CST,PUCT NF_ W CDNCQETE 5/DEWA,LK <br /> At the following Iceation ZZ D 9 CULQ�/ f4VE j <br /> SKETCH I� <br /> (Work to be donel n���v . , <br /> !-4 l <br /> II <br /> - � �--� C� <br /> NO SCHl� � <br /> 220 9 <br /> ' IuEW C�NL�PETE <br /> LA/VDSC/�P/NG 5���� <br /> i <br /> � _ RE/�LACC D<IMtaG'E.D <br /> � ' ;�=.�5/DEWALI� o�c:—,�,,,�, <br /> � y ii-i3-�,� , <br /> O <br /> ? <br /> N - -- __._--- ------- ---------- - <br /> �I 3(0' II <br /> , COLB`� AVE. ,.,". <br /> , <br /> �� DRNEWAY SECTION The undersigned owner hereby agrees to hold and <br /> � NO SCALE save harmless the City oi Everett from any and all <br /> ��, - - claims tor Aamages that may arise because oi insialla� <br /> i � tion and maintenance of the improvement hereto <br /> , applied 1or and turther agrees to remove same upon <br /> I E " 0" ����.{ notice irom the City and to replace public property <br /> ' damaged t kr y. � <br /> �y���,.�..� <br /> � Signature of Applica t , <br /> ICOPY 01= THIS APPLICATION TO Ad� _/,_, /!� <br /> 6E POS7ED ON JOBSITE. I -�-phfJ'T� l a ,� 7�� .�� <br /> � C�aLI EfJGINEERING DEPT.259-8811 � Telephone Number <br /> �r ��'3�-i 3 �S- <br /> I 74 HOURS �EPOFE CONSTRUCTION L1wpl i7 Date <br /> U /Yd F,[rG� <br /> CHECK LIST � Fee <br /> Water valve Dept. Ap rova <br /> Drainage <br /> Curb&Gutter Engineers �� '� �i 2��1�+ <br /> Sidewalk Water J <br /> ` f ' , <br /> _��• _ <br /> � �,( Street <br /> �,c;/ /`/v>/�' � Communicati ns `�� �'�� <br /> Inspector'sSignature /J �_ <br /> TraHic �-z� � <br /> 7 � Planning � ' — �='I�'1� <br /> //'/3 - s � — <br /> -6ate �^/ ) <br /> �'UU �i'JS� C/���Of/1 �/Z 1� /4^���:i�u,. <br /> Remarks <br /> Note: Original to Customer 1 <br /> 1 Copy to File 1�'L?3 <br /> 1 Copy to Inspector Approved b �� /� ��,�'�'� G F7�'/� <br /> �� <br /> � Date Approve " <br />