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i <br /> APPUCATION FOR RIGHT-OF-WAY USE PERMIT <br /> everclt <br /> e �06�2 <br /> CITY ENGINEERS / I <br /> EVERETT,WASHING70N__ PERMITNO. �'�[� ; <br /> The Undersigned I,'c �s V h n c�� <br /> Hereby applies for permission to. Rc��v�n.,♦ A� , ,-r F ; Fr �-f r� � /! �� O G�f A"O v% <br /> At the following Iocation�"7/'� �.,//,:, ' <br /> SKETCH <br /> (Work to be done) <br /> � ' <br /> n � <br /> � � .-/" o � ,v � <br /> �7i�- 7 � °i <br /> ° a � k� � � <br /> � ���6� ti '- • o <br /> ti <br /> ' — <br /> /N�., we —i� <br /> - - -{- - -'¢ [rar9- - - <br /> CaJby (���. y` <br /> � <br /> DRIVEwAY SECTION �'--�` The undersigned owner bereby agrees to hold and <br /> , No SCaLE-- -- save harmless the City ot Everett from any and ail I <br /> r-- -� claims tor damages that may arise because of installa� <br /> p' �ip � tion and mainrenance o( the improvement hereto �, <br /> 30" __ __ I Dp'� � , . (uriher agmes t r ove�Same on I <br /> -�i'--"1 notice from City and to�a public pr , rty <br /> , dama�e here4y. / ,� /^^ I <br /> � �� �� � <br /> vV� <br /> Sig�t�e�f qpplica � <br /> COPY OF THIS APPUCATION TO A� � � <br /> 9E POSTED ON JODSITE. p� � G� ,� <br /> I CALL E�dGI��'C.Pf?I"dG DEP7.259-8811 Telephon Numberf ! � 'i <br /> a� J <br /> ;: HGU���:; �a[�"r,i16 CONST{iUCT10N Dat> � <br /> CHECK LIST �n ��� � �I <br /> Fee <br /> Wacer Vaive Dept. Approvals <br /> Drainage <br /> Curb&Gutter Engineers���,'�* >" �Z���__ <br /> Sidewalk � <br /> Water <br /> �Street �Z�a.r ' ?. �i'- -7' . <br /> _ Communications <br /> Inspector's Signature Traffic � <br /> Planning <br /> ate — <br /> ♦ Remarks <br /> - .�- - <br /> Note: Original to Customer ry�+pr� , <br /> lconvtoFile ,,I.IpJG �� <br /> . 1 Copy to Inspector Approve�b� ,�- <br />` _ - ;� . .�-. ;� .l_ - <br /> I Date Approved <br /> l <br />