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everett APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br /> • � _ 10429 �,,� <br /> CITY ENGINEERS � �� <br /> EVERETT,WqSHINGTON PERMITNO. 7�n"' � �o <br /> The Undersigned r T%' <br /> Hereby applies for permission to , ' ., <br /> o _ � T H ,_ _LS_ � /e n v✓ � <br /> At the following location <br /> SKETCH <br /> (Work to be done) ' � —��� � <br /> �{� _N � � <br /> . �Siw q• , <br /> � � 3. <br /> O `� �0 V <br /> G <br /> -�° o cSJ, 2 2Monrcck; - /D' <br /> � a � n in fro�n �nvE�nen7�' <br /> �, � v '� o ti' � �� c�I�e � <br /> ;, p <br /> � � �' I <br /> c p^ A.i�l�/�unc� �0' � u , <br /> E 51r�p �{�E�/P!I ! o <br /> � � C; }. 7-1-4.: <br /> � � � � 1(l� <br /> Q J <br /> u <br /> � <br /> J <br /> L <br /> � � W <br /> a � <br /> i '� Q <br /> � mnn rr.lk.` - +A� �U � m � <br /> in iranl (�nvPment � CI .� <br /> -.r�� id b 0 <br /> � 4730 V <br /> �'9 b i <br /> e/w p�..� <br /> � I PRRltING nI' � <br /> , � �I' i <br /> ) I�ij1`^' � f I <br /> � w <br /> DRNEWAY SECiION The undersigned owner hereby agrees to hold and <br /> .� NO SCALE �1 nY to Sfr e, Ip save harmless the City of Everett from any and all <br /> ' � — --� �,,.p�� p� � � i laims (or damages that may arise because of installa� <br /> :.i.n-� <br /> � �1 i° ��P ����ion and maintenanca of the improvement hereto <br /> i �30';,I _ ____ _ �30� I applied for and further agrees to remove same upon � <br /> 1 '� notice from the City and to replace public property <br /> idama th bK <br /> � S�g ature of Ap i ant I <br /> — � _Ldr��O�� � I <br /> � COPY (�b 71i15 Ai'PLICATIOfd l n � Ad ress � <br /> BE POSiLD "JN JOBSITC- �, � O� <br /> CA(.L ENGINE[!?ING DEPT. 259-8811 Telephone Number <br /> ' , ".i i+�ii.li?; f3.'-Fpq[ COfdSTHUCT�QfJ �_ �_ 1� <br /> Date <br /> CHECK LIST Fee u� <br /> Water Valve <br /> Drainage ,,, , D t. pr v <br /> Curb&Gutter � �� ' � Engineer / � <br /> Sioew=lk <br />� - , � Watcr e Qh e r eCiSc r � <br />� ,�/ �.. `�'` , i • <br /> �''..�� St�eet t, : �,;,, <br /> InspectorsSigdgture Communicati s � � <br /> Traffic � <br />� '� `" � � 7 Planning � !� / . .� 4 : '�� � <br /> f �� � �, Ser.i�r �f,/, C�'?'�cn,e. ,o _.�C�-h /.3 <br /> :_-J����•�-�!'�' �1✓° �rdr.�:�,,. -- <br /> �� Remarks - <br /> Note: Original to Cucromer . . <br /> . 1CopytoPile 10429 - � � <br />' 1 Copy to hispector Approved by � / <br /> i <br /> ..:5� <br />. Date�P, roveJ <br />