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APPLICATION FOR RIGHT•OF•WAY USE PERMIT <br /> everntt <br /> � <br /> CITY ENGINEERS i'�/ <br /> EVERETT, WASHINGTON PERMITNO. � j` � <br /> _! � <br /> The Undersigned ��f.�/.�.'�'T i,l ' B�/!?G_ <br /> Herebyappliesforpermissionto,f.��c/5���!' �- 2.� �-/i�",?f,�fa-L"r� ��i <br /> At the following location ���/n �fl���"��, =�.1 %%1�� <br /> / <br /> SKETCH <br /> (Work to be done) <br /> �� � � �.l�;-1�, ,. . _ .. <br /> � ;�;�« <br /> . . , <<�:'i:` .� <br /> 3 <br /> DervEwav SEci�ON The undersigned owner hereby agrees to hold and <br /> NO SCALE �- save harmless the Ciry of Everett from any and all <br /> f'- � claims for damagzs that may arise because of in:talla- <br /> +I" LIP �� tion and maintenance of the improvement hereto <br /> 30'� �3p�� applied for and further agrees to r ove same upon <br /> notice f m the City id to re I e pub�l'¢ property <br /> d ed there y, ; (/ <br /> ��� <br /> ` ignamre of App icant <br /> f.�. �a x /o S�3 <br /> COPY OF THIS APPLICATION TO � Ad ess / J ' `' <br /> BE POSTED ON JOBSITE. �%l�it��t-°oaC� , �VhB , r,�'"v3�" <br /> Telephone umber � <br /> CALL ENGINEERWG G[PT. 259�8811 �e�� <br /> 24 HOURS [3EFOR[ CONSTRUCTIONI Date <br /> CHECK LIST Fee �%�� �_ ?_' <br /> Water Valve Dept. Approvals <br /> Drainage 47 � �' <br /> Curb&Gutter Engineers_ �- � i1.' l v-�' � <br /> Sidewalk Water <br /> i'. <br /> I> Street . � <br /> I Cammunications <br /> Inspeclor's Signature <br /> Traffic <br /> Planning <br /> ate <br /> Remarks <br /> Note: Original to Customer <br /> 1 Copy to File ' t <br /> 1 Copy to Inspector �- '� � 1 Approved by <br /> Date Approved <br /> ,.�_._..,_- . . . <br /> I <br />