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APPLICATION FOR RIGHT-OF-WAY USE PERM!T <br /> everetl . - �O� n � <br /> e 4 <br /> CITY ENGINEERS <br /> EVERETT,WASHINGTON PERMIT N0. !/. ' •� �'�. D <br /> TheUndersigned�_3.�-tN L /-�.�„r�., <br /> Herebyappliestorpertnissionto Cr.,,s'�vrir� .� $�,,{� �'!_ 3��c /-/vd5c n.n SkiJc �� �• C.t�, 1� �? v,� <br /> Atthefollowingioeation ? k// /'i�/6� - - I -, f��:n't n� �aec��e ��iv�.�- S <br /> J <br /> SKETCH <br /> (Work to be done) - <br /> � <br /> C'C/fx, Hre <br /> D,�y, �< Ru<k � � � a eS fi _ n� � �` —� '�i <br /> to e c (l,cn,rv: � �----� r : � � <br /> � � _ $Anld�s � � �� <br /> t� <br /> /��,✓�`'Q� <br /> ', E,.t�� � . <br /> � "D�Hrhan9 IE--��'g"�� S��wn/!c <br /> _ � <br /> ��•�, n_____� -" �� <br /> � N�Lff. �,.J✓I Jt N¢��+rC�C � <br /> � <br /> �iollzCt��� �ayor (�.lw.�dh I I�OtQ. Mln�r+w�n <br /> -�---_: San1r L/a�seHo•s� s f/ � P�dest�w� YJo/kV✓ey � <br /> /�y�re,'ate S�devd3/ � g' �,o�r �ast ��/d// <br /> Gee.oc� aSii t'a�b of SDn�� k�°setd <br /> y ���z. <br /> 7rv5t CaSeade �v,ld�^y Snon p.QtS NPOnn <br /> � Sdviny5 f SAo¢S ' <br /> j(ena,, saop A�d ii <br /> I <br /> � DRIVEWAY SECTION lhe undersigned owner hereby agrees to hold and <br /> NO SCALE save harmless the City of Everett from any and ail <br />�� ' r — - � claims tor damages that may arise because of installa� I <br /> I" LIP tion and maintenance of the improvemcnt bereto ' <br />' , aryplied for and further agrees to remove same upon <br />� 30' 30 notice from the Cit and t re lace ublic property <br /> I -.f._—•--- __—.#.__�� Y P P . <br /> damage ereby. <br /> II Signature licani �� <br /> I - - - -- ---- _i Po���� �'3a - z.,,1-,Q� <br /> f�COPY OF THIS APPLICATION TO Address <br /> I I BE POSTED ON JOBSIT-L I� GS-1 "' SI�( <br /> Tele hone Number <br /> CAt_l [fdGINCfRiVG DEPT. 259�8817 � n�� _��_ ��_ <br /> ' � 24 HOUR:; [3Ef-ORE CONSTRUCTION j Date ' <br /> �, /��7 i'i`r-'_ � <br /> � CHECK LIST � � Fee ' <br /> � Water Valve <br /> Draina e 6 ! /r� ' Dept. Approvals <br /> I 9 /�'t i; +f �_ ,LEl.� ._ �/i,re.i..,_ . sra,'.n-... w n:-• n"' �� <br /> Curb&Gutter I�� � Engineers G ���%.1,`+..ti' iif�?6 <br /> Sidewalk ��,-°-'+'� � ��/ �'1'7 z -, <br /> � Water � : '_ 1.,� . �_ <br />� , �is, �,-> Street ,� i�. �� �r ��-�� ��/. . <br /> ' .. 7 <br /> � � CommunicaUons �� <br /> ! Inspector'sSignuture � �%i, ' <br /> � TraHic -���--� // <br /> ._ Planning / r_/� � <br /> i ate - <br /> C <br /> Remarks � �- � �� <br /> i <br /> ' Note: Original to Customer <br /> 1CopytoFile 10645 � <br /> S q 1 Copy to Inspector Anproved by <br />�� � � Date Appro��ed <br /> / / � � li � <br />• . , . .. i � . '1 . _. � . ' .. „ � - <br /> \ <br />