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APPLICATION FOR RIGHT•OF-WAY USE PERMIT <br /> .�rvcrett . �03� �1 <br /> � ,, r;i,'� ,I;, �t <br /> CITY ENGINEERS � '" - � � <br /> EVERETT,WASHINGTON PERMIT NO. ' " � l t�F- 1 <br /> TheUndersigned_�.y�'�C� � -Z.� J GGOw'NS <br /> Herebyappliesiorpertnissionto �"�`- 0� 7� � /�lGFS�L� *-/ r.�t� GN C� T <br /> �,<<- �e-,�r /�-Z�- �Z-29-7 / <br /> Ac the following location Z�G C-v L.$� S�/�J l p--,-r� ,�LG � ��,/�✓ <br /> T" <br /> SKETCH <br /> (Work to be done) <br /> �� <br /> ;�iYN ��►G l'�'�� �J <br /> �3/CEI� � <br /> i� <br /> SiDEv✓AUC R�cEf) ' �• <br /> Q <br /> \ <br /> ( '` <br /> �,:. . . , x ,� �,, <br /> � ( .. <br /> �' N � � '�� \ <br /> ~J' - . , � �, �/�/� io' �,� �l� <br /> V` \`\•��`'..)_'�1 i.�. �` �,�\' '� 'l I <br /> � <br /> PRaPasEo s�vNr,� ���5 <br /> i NUU.5�� /o' Y 36� M0,6/!� H'GY�1E <br /> � CU�/.�y' RVEiV�J� � <br /> , � � DRIVEwAv SECTION The undersigned owncr bereby agrees[o hold and <br /> � � . NO SCALE save harmless the Ciry of Everett from any and all <br /> _ . r.- - —� claims for damages that may arise because ot installa� . <br /> '„ L1P �1%�� JY �-�r tion and maintensnce of the imprWdment hereto <br /> , applied tor and fur[her a9rees to removx same upon <br /> 30" _ _�„3o�.., nolice irom the City and tb replace public property <br /> damaged theroby. % , <br /> I : �- _ C /� �<<� <br /> �i SignaNre o�{tpp�ca�t 'T <br /> '. /%��.: ���G�tJi' r IZ <br /> �i COPV OF 'fHIS APPLICATION 1'O �, Address _._ [ /� <br /> I BE POSTED ON JOBSITE. ''� I Z - a L� � y <br /> I` . TelephoneNumber -� ,� <br /> � CALL ElJS!'�,!rIiRING DEPT.T59�081 t / � � �_ <br /> . 24 IiUUI;._�. L'Cf ('.RG CONSTRUCTIOfd� Date �/) <br /> � - - -_ ------ /Y��JI� <br /> CHE^K LIST Fee <br /> Water Valve � � , - DB t. prOv FS ` / <br /> �� Draina9e �� , � ///�f'/-Is <br /> Curb&Gutter Engineer � i <br /> ' � ' Sidr.walk Water �� S 5 <br /> ly <br />� �� Street�'�/�', /I' -'J1 � <br /> Communications `� � �-"`������.���31 <br /> , y_ . / <br /> Inspector's Signature Traffic )� <br /> Planning� � C �—' 7�� <br /> Tiate <br /> I � � � � � <br /> Hemarks i� i" ' <br /> [i�6.. ��- �. :: � <br /> Note: Original to Customer <br /> i�",T�o_ /__�' <br /> , �o�� �o F��e � ��3 4 .w����-�-��� <br /> 1 Copy to Inspector �� S��y,,,Y _, <br /> V � <br /> i � Dafe Approved <br />