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APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br /> everetl .-- 1 0 6 6� <br /> ' � <br /> �CITY ENGINEE!'S � _ 2� , <br /> EVERETT,WASHINGTON PERMITNO. � 7 � <br /> The Undersigned�ef L%�r � ✓ IVI ' � G Cy$TrM C ( � � l ' � �� ' � �' �— i <br /> Hereby applies fo� pertnission to T r � ? 3c ��'� r.� s - �� // � f!.�� o P{ n� ��,.% � <br /> ,f I <br /> (�] 1 r ✓ �3 f � '�h �i f � 2 '� �h / � E O b� �;�t �/�,• -f.T�7�7�Si.�` <br /> At the following location %� �o�6� �/� •� - t �at -f o� ( �'i�'I. <br /> ��� � l lC � r /�1�.> � " 3 ' � i <br /> SKETCH I <br /> (Work to be done) ' � <br /> � <br /> I <br /> _ � � <br /> • I <br /> SC�C� fi �L�..3i.'�ks':� � <br /> J e e �,cl.C�. $�e0 el��� ?t '{ l�-.2- 7� <br /> � <br /> � <br /> ORIVEWAY SECTICN The undersigned owner hereby agrees to hold and <br /> N� SC11LE save harmless the City ot Everett from any and all <br /> {.-- - - �--� claims tor damages that may arise because oi installa� � <br /> i <br /> '„ L P tion and maintenance of the improvement hereto <br /> app�ied (or and lurther agrees to remove same upon <br /> � �30'�_.__ _�.30�� notice from [heCity and to replac�e bl��fi ic pr�e�H� ` <br /> damaged thereby. = ((=1COlr..cYF ll4e�� <br /> Si�re ot AppliC�nt, ' � � <br /> �� /9- �� �� � <br /> COPY OF THIS APPLICATION TO Address <br /> BE POSTE!]ON J06SITE. ^� �� � 7� � � <br /> Telephone Number <br /> CALL ENGINEERING DEPT. 259�8871 /2 - � _� � <br /> 24 HnuRfi �f-FORE COIJSTRUCTIONI Date <br /> , . _ . _- - - --- -- -- _�l i <br /> CHECK LIST �� Fee <br /> Water Valve DBpt. Approval5 � <br /> � Drainage � <br /> Cur6 &Gutter . Engineers <br /> Sidewalk Water <br /> � Street � <br /> �, Communications <br /> I spector's Signature Traffic <br /> �-�— Planning <br /> ate <br /> ��U nk � .l.X �1� <br /> Remar�s-'�` <br /> Note: Original to Customer � , <br /> 1CopytoFile �_ n660 � <br /> 1 Copy to InsPector Approved by / � Z ,�x,, �i i <br /> Ls� <br /> f /OV <br /> Date Apprm�ed <br /> � <br />