|
APPLICATION FOR FiIGHT-GF-WAY US� PERMIT
<br /> �vcrett
<br /> - e �0586
<br /> CITY ENGINEERS �
<br /> EVERETT,N�ASHINGTON PERMITNO. � �� - ,
<br /> The Undersigned K � ' !.� - C ,� I� l,�,c 1
<br /> Hereby appties for pertnission to r_ c� • 1 r.�r! � t ��vo c n n c r r yi '�, �_ - . _ :� �
<br /> c - .-, �_/ � �
<br /> At the following location .3 �i(��' C .- I �
<br /> SKETCH
<br /> (Work to be done) �
<br /> ' I
<br /> I/�
<br /> `, ,:r .-,. � 7.
<br /> �_ _ 1_� �i �,c.vei�.
<br /> 7 -- --IT
<br /> i '
<br /> � ---�: -- — �—.. -- --�
<br /> i . J I• �. � I. YY� �a�.
<br /> � '.. � I�'�T \� ��.�.��.:_ `�-``���` ���.�'{
<br /> I ry + I
<br /> �� � I
<br /> I.
<br /> '";� " i _ _ '___ __.� I .
<br /> ' , , .i , .. • � , I � ,
<br /> i
<br /> i
<br /> , �� i i i
<br /> � 7,'S:: -- i _ , i�. ; �i
<br /> � � — - _. �'�. "j �
<br /> R
<br /> � + �/�/ot¢, sec Rffactted ;
<br /> m � • �� I
<br /> .� I ,y� '
<br /> V I
<br /> � �
<br /> � � , ., , h ;
<br /> � /-��:
<br /> �ii DRIVEwAY SECTION The undersigned owner hereby agr^_, to hold and
<br /> � NO SCALE save harmless the Ciry oi Everett trom any and all
<br /> '' ���' -� claims fordamages that may arise because of installa-
<br /> �
<br /> +�,� ��P —�1 � tion and maintenance of the improvement hereto
<br /> ;pplied tor and turther agrees to remove same upon '
<br /> �30'�j„_ ___,�3�",� notice from the City and to reptace pub�ic pmperty
<br /> damaged thereby. .
<br /> � ����.i �-�- /,-�� /J, _�,- - i_ �=� �
<br /> ignature of Applicant ' .
<br /> � '�,� ,.,' '. . - / r
<br /> COPY OF THIS APPLICATION TU Address .
<br /> BG POSTED ON JOBSITE. � `. _, '; r . II�;��
<br /> Telephone cmber
<br /> CA�L ENGINEERING DFPT. 259-6£it 7 - -- ,� _ ��
<br /> ?4 HOURS BEFORE CONSTRUCTIOiV� Date ;. -
<br /> : �,. -.-•-{', . . _ .
<br /> CHECK UST Fee /G. �l /��/.T
<br /> wacer Valve Dept. Approvals s'
<br /> Drainage . ,.. � �
<br /> Curb&Gutter Engineers��ll
<br /> Sidewalk � D ��r � ,.
<br /> n Water,� . �/.��.. ['�o. /l7..r�- <r .�% ,v_'
<br /> ,� %� Street
<br /> � ��. �� � �' Ccmmunications - ' J� ' ' �
<br /> / =�_5��„ /
<br /> ! npectol SignaW iy � t
<br /> Tra(tic y /,.1 /�i
<br /> : �
<br /> � / y C,C, , �� � Plannina � _�� . .
<br /> �e
<br /> �
<br /> �,_i�T �7� -/ /���
<br /> Remarks
<br /> Notc: Original to Customer
<br /> 1 Copy to File '� �1��?,�
<br /> i Copy to Inspector � Approved by
<br /> Date Approvcd
<br />
|