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' ecemtt <br /> APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br /> � 10102 <br /> CITY ENGINEERS � /f /� i <br /> EVERETT,WASHINGTON PERMITNO. L , <br /> The Undersigned � (!•/ �� �/���0 �� <br /> Hereby applies forAertnission to_ .AJ(/.ST lJ�T /UE�lI/4�/ �/V�,PjFPE � <br /> k7rt�.� ,c�E/'�9ii�' -s�G��'Gu.QLn /�.� �'r �2/-r t�) ' <br /> At the following Ixation ���le l°nL RS� ,4�/r <br /> SKETCH <br /> (Work to be done) ; <br /> I <br /> I <br /> /'�I�/��/��OS�"/� Lq.�Ji7SC.a�/�/G <br /> � �• <br /> 3----- <br /> �— /�Ro/�.r2r1' v�v� `� � <br /> �' �w <br /> /— f%eoBoSe � Cc.vt D��,tl TD <br /> / / R_Fj���J�r_' E�/�TiIY� .D/j,v <br /> _ _�. <br /> i --r--- — -----— — — - <br /> i ��, Ph`I ►-�-� , <br /> � � p,�� �-�°c°c � 4 <br /> � /�s, � <br /> i ��� `iG� � �/ l� � , <br /> —�xiSri�u[, cu�u, cur <br /> � �d C;u/Z�;' jC L(/T7'� <br /> � _.._._-_---- --_ --- -f------ <br /> ���P� <br /> � — --- ---- �' <br /> lZEALACE Ex/s>i�v� co �.�Y �y vF <br /> � Si�E WAL,FS <br />, ! ORIVEWAY SECiION The undersigned ownel hereby agrees to hold and <br /> ' NO SGnLE save harmless the City of Everett from any and all <br /> � � �� � claims for damages that may arise because of installa� <br /> I 'I ��� LIP tion and maintenance of the improvement hereto <br /> �30'�� �� / . I 30" applied for and further agrees to remove same upon <br /> —��' notice from the City and to replace public properiy <br /> , dar aged ihereby. � <br /> 4 4?. .- ri�.�.�>,. �e ,. <br /> „� , � . <br /> Signature of Applicant <br /> I -- ��.2 iv,v/�,rc � I1` Sv,�,� �=��oy <br /> COPY OF THIS nPPLICATION TO l Address <br /> I BE POSTED ON JO�SITE. I _ �,� ��, y,/ <br /> , CALL [NGRJEERING DEPL 259-9ii i i I Tetephone Number —7 <br /> �� — � � — / <br /> � <br /> i�' IIf71�R5 (�EFORC G(if�JS�P.'ICII(7N,• ��/�� Date ff <br /> I CHECK LIST /� /�,/p/1, �n�/ � /�` <br /> I . Water Va!vc �'b� � '" ,�[ Fee /�'� ��i� <br /> Drzinage I '� /a—��— 7 Dept. A prov Is <br />� � . Curb&Gutter b Engine � � �,� <br /> Sidewalk � � 0� /jA� ` ' <br /> (� �t �p� I a �� Water <br /> �� O 1 15 ��(� �� �ui4 ) ; � a� Street �5' ��% _ _�;f�? �-- <br /> �___�9 ��J d�1 Ya+� �Commuriications��.+ � •��- <br />' , Inspector'sSignature —�1 � J� /Qp � .� <br /> �1 1 ��151�/ Traf(ic x�.� � . . � � :�ii �7� y� <br />. , �1e'� _7 � �� Q '" r%/,1 �} Planni _ (A /�6,���— Z"YY I <br /> �~�'. <br /> Remarks <br /> Note: Original to Customer /� �` ��^'" �' '`"'""' `� <br />� 1 CoaV to File � n'�.ll 2 SY,.,T� �.;', T' � � <br /> 1 Copy to Inspec�or � Approved b�I'� ' <br /> ' <br /> a[e A prov��` /� ��—� <br />