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everen APPLICATION FOR RIGHT-OF•WAY USE PERMIT <br /> • � 11 � j [i. <br /> CITY ENGINEERS <br /> EVERETT, WASHINGTON PERMITNO. - ' - � " <br /> The Undersigned � <br /> Hereby applies for permission to � . � <br /> At the following location � ���� I <br /> SK.ETCH <br /> (Work to be done) I . <br /> � . <br /> 5�0 � � i <br /> � <br /> r�,;�;C-2G:,J i <br /> � <br /> I ----- i <br /> r;�rir:; r� � <br /> r�����C�: s <br /> --------� <br /> I � � <br /> �— -— - ------ I <br /> � I � <br /> � � � � � <br /> ---- .�. � _ ._. . __.__.._' <br /> _ :' ' ' 1'!.'uPost r' ANriN(_ <br /> ' e✓ <br /> ����� � Ul: �i S �0 :/''Hik� i I � � ��pT ��Oj�j��C� <br /> ud G/iTTf�l S � .'cp//,1� � �,�� � <br /> �, �r/�� �i'olE <br /> �_�. i <br /> ��/i-'�(.lf'�r ✓✓ I.�l ���/ . <br /> � <br /> � �,1-�Y.����.1�`'�'11�)�_1 1 '— �I �c � '-�',' � � ""�`- <br /> , �� � , <br /> � i , - ' ,�(- ' � .I ( , ' <br /> `�;� 1C.� Ef� � - �� , _ <br /> DRIVEWAY SECTION , ': � ��- � , !�I��� �� ' The undersigned owner hereby agrees to hold and <br /> , NO SCALE save harmless the City of Evere[[from any and all <br /> r---- -� claims for damages diat may arise because of installa� <br /> I�� LIP tion and maintr.nance of the improvement hereto <br /> ��3p�� �30•, • appiied f��r and further agrees to remove same upon <br /> notice from the Ciry and to replace public properry <br /> damaaed there6y. <br /> Signature of Applican[ <br /> COPY OF THIS APPLICATION TO Address <br /> BE POSTED ON JOBSITE. <br /> CALL ENGINEERING DEPT. 259�8817 Telephone Number <br /> 24 HOURS BEFORE CONSTRUCTION Date <br /> CHECK LIST Fee <br /> Wa[er Valve � <br /> Drainage Dept. Approval5 <br /> Curb&Gutter Engineers <br /> Sidewa�k <br /> Water <br /> Street <br /> Inspeclor's Signature Communications <br /> Traffic <br /> Planning <br /> ate <br /> Remarks <br /> .. - � �I <br /> _. . . , � <br /> Approved 6y <br /> � Date Approved � <br />