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cvcrett <br />� <br />CITY ENGINE[RS <br />EVC-RETT. WASHINGTON <br />The Undersic�ned � ' <br />Hereby applies for permission to _ <br />At the following loca[ion � ��_� <br />(Work to be done) <br />`i' <br />'— �c__�,_,.. <br />APPLICATION FOR RIGHT•OF•WAY USE PERMIT <br />i.0661 <br />PERMIT IJO. � ' <br />\ � � <br />� A � <br />\\�� ` �\\ \ ��\ ��,.\ �' . . . <br />� \ _--___._. <br />Y j �-i: � r� �� \ � <br />� `\� \ � <br />\� \ � <br />i <br />I i <br />`� � <br />c ' <br />i.�l � ��.� . . I <br />���1,�t I��� ' � I � ' <br />\ \ \ `� `\� � \ � � � � �'\ \� \ \\\\;\``, <br />\ \\ \ \\\'�' \��\\. <br />'�\ �\ ��. ��\ ` `� �� �•;� <br />\- \- �\\ � � ----�-- -: . <br />\ � �.._ —� � \ � p..�,�r,.c._� :r� <br />` In-/•�., '•�=^h�q7[. <br />-.,C,. <br />�-, ..�..._ - �> I � � � ��-�''._\ . '�.I <br />�... r�.:.; �_ ` i � <br />, � ; `� � ,-i <br />�.� , <br />. , . <br />DRIVEWAY SECTION <br />NO SCALE <br />� � ` <br />I�� LIP <br />�30 — —.__— I,30�� <br />.J. <br />COPY OF THIS APPLICATION TO <br />BE POSTED ON JOBSITE. <br />CALL ENGINEERING DEPT 259�8811 <br />24 HOURS �EFORE CONSTRU�TION� <br />�temarKs <br />� Notc: Original to Customer � �r� <br />1 Copy to File p� 6.t <br />1 Copy to Inspector <br />7 <br />�- � � -' The undersi9ned owner herehy agrees to hold and ' <br />save harmless the Ciry of Everet[ from any and all �. <br />i <br />claims for damages that may arise because of installo� �, <br />tion and maintenance of the improvement hereto ��. <br />applied for and further agrees to remove sam��on , <br />noty��from-th�tJ y and to replace ubli pmperty <br />�' <br />�r�a ad-�by. � �• ; ; . <br />_� : I �. � J�i <br />gna e o Ap icant <br />/.� y'-� v � ��; �,,,. � c-v.a � <br />nda�e55 <br />�'S3-�S�? <br />Telephone Number � <br />�-'T`_`� �z-�-76 �, <br />Date <br />Fee <br />Dept. E�pprovals <br />� ;, <br />Engineers % <br />Water�� �;i., �, . F.,i� ._ i;' (.1.'� IL�i;��-� � <br />Street <br />Communications � � � - <br />Traffic <br />Planning `� - <br />�'_�, I�_!C�i,.r�.. _ I_i.c 1�=y �-i�.. <br />Approved by <br />; <br />Date Approved � <br />\ <br />