APPLICATION FOR RIGHT-OF-WAY USE PERMIT 11312
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<br /> CITY ENGINEERS ' {i,Z � -7
<br /> EVERETT,WASHIfJGTON PERMIT N0. � /
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<br /> The Underoigned ' �-t_ � f"�� h t^-f __
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<br /> Hereby applies for oermission to "a�� ;,� 1 +i,- � r :� o ,, ,. -, /f.;':��...v ;.. : �
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<br /> At the following location .�_7 .n�7 �t-. . � o�. � _. ... ... �-r.�� . . �
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<br /> �RIVEWAY SECTION The undersiqLned owner hereby agrees to hold and
<br /> NO SCALE save harmless the City of Everett from any and all
<br /> �- � claims for damages that may arise because of installa•
<br /> �" L�P tion and maintenance of the improvement hereto
<br /> applied for and further agrees to remove same upon
<br /> r30" T T 3� notice from the City and to repiace public ryroperty
<br /> damaged thereby:� � �
<br /> �)� � .,.,.��,.
<br /> Signatur— e of Applic� f ` "' / r
<br /> COPY OF THIS APPLICATION TO
<br /> Addre s i �. ��.... .. � /��.J. d �f
<br /> BE POSTED ON JOBSITE. ?r-�- �/�- '�' —
<br /> Teiephone Number
<br /> CALL ENGINEERING DEPT. 259�8617 y _ � _ ) �/
<br /> 24 HOURS BEFORE CONSTRUCTION Date ' -�
<br /> CHECK LIST Fee ' ., :� ' 1-•
<br /> ; _ /`� ,.�1,�..� _ 3: 2,�.1 � .
<br /> Water Valve � �
<br /> Dept:ApprOVals �;+�
<br /> Drainage � �
<br /> Curb&Gutter Engineers
<br /> Sidewalk Water
<br /> o� Street
<br /> ���n,�U��/ Commur.ications
<br /> Inspector's5ignature ,! Traffic . .
<br /> � S'i '7i Planning �
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<br /> ate
<br /> Remarks
<br /> 11312
<br /> � Approved by �� �:i �--
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<br /> � Date Approved � j;� �' .,� 0
<br /> - � INSPECTOR'S COPY �� ,/ �U/7 �{` .
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