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_ _ -� <br /> I <br /> APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br /> everett " - . <br /> � �e <br /> CITY ENGINEEFS � �� � ' <br /> EVERETT,WP.5HINGTON PERMIT NO.�� <br /> The Undersigned /' ' ' � -� " " _ . " ' � ��•� �' F.^o,r�'f � CG i,r.-� �- - v.r,- y,-h, �� � <br /> Hereby appliestorpermission to, r'��A-���° �- 3S ��_� Y c ?at-e� n /' /h • � t�e � ..�nas� vf n�����o I <br /> � <br /> C� �� � � qt -1 2�ho �OiGs� f �cr �1e �4e ✓ r� �e�a{ O n Da� 'Sdt ���/ '!'^JAi�I'SCv , <br /> At ffie tollowing location �- `� / ^ J� �' � �M , <br /> 7'c� i fl� G e;�i� /✓r„� /...,. ., � <br /> SKETCH <br /> IWork to be donel .� Q � � fa J /.,/ <br /> i <br /> � � i .�. . . ' �, <br /> �� '�'- <br /> I <br /> I <br /> DRivEWAY SECiiON Thc undersigned owner hereby agrees to hold and <br /> NO SCALE save harmless the City of Everett irom any and all <br /> r ------� daims for damages that may arise because oi installa� <br /> �'\ �I" LIP tion and maintenance oi ihe improvement hereto <br /> appiied for and further agrees to removc same upon <br /> �30'�J„_ � _ . ._�.,34�� notice irom the City and to replay� ublic property.( <br /> � � � damaged thereby. "" C�L4+�cLL� _ �U��r.c+.,� <br /> �`����'� �'. �� a'�.'``� <br /> Signa re of Applic nt,��/ <br /> �) �`�— �-�n.��I.. �, <br /> Address <br /> ' �;U1�Y i,: I��.I IJ r"-i'�'LI1:l.i I�_�FJ l l: ��� ' �� � � <br /> Ii. i�OSi[OONJOBSITL. � TelephoneNumber <br /> , !.:"�.LL ENGINEEHING DEPT. 259-8811 !�_ � _��' <br /> ;.� I i�:iUNS 11fF(1HL �:Of�;1NUCTION Date <br /> i � <br /> S/J .,° <br /> �CHECK UST f-eu ' � <br /> Water Valve Dept. Approvals <br /> Drainage <br /> Curb&Gutter Engineers <br /> Sidewaik Water <br /> r, �� Street <br /> � Communications <br /> Inspector's Signature Traitic <br /> �� / � Planning_ <br /> �te r <br /> ��v �€�L��-� <br /> Remarks <br /> Note: Ori9inal to Customer 7 <br /> 1 CoPY to File �� n ('7 j �� , <br /> i CopY to inspector - � � Approved by � / � � ��/ <br /> Co.� Gw.....t / <br /> Date Approved —� �� <br /> \ <br />