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�����n <br />� <br />CITY ENGINEERS <br />EVERETT.WASHINGTON <br />APPLICATION FOR RIGHT-OF•WAY USE PERMIT <br />" 10353 , <br />�����,�h� <br />� <br />PERMIT N0, �Jr -J <br />The Undersigned <br />�. _ r_-- -� �U�.�i : C.? <br />�� (Work to be done� <br />r <br />Fj; /.�Ti�UC ,� 5, �-: ;=�L ,"` <br />U�i Vc vY'� Y <br />L� <br />0 <br />DRIVEWAY SECTION <br />NO SCALE <br />� � <br />I" LIP l <br />L30" _ I .30" <br />i- <br />� COPY OF THIS APPLICATION TO <br />BE POSTED OIJ JOBSITE. <br />�' CALL ENGIN6ERIDlG DEP'L 259-8817 <br />. 24 HOURS LEFGRE CONSTRUCTIONI <br />CHECK LIST <br />' Water Valve <br />��, Drainage <br />� Curb & Gutter <br />Sidewalk <br />� � 2> <br />Ins ector'sSiqn ture <br />--,s�-�— �� — l v <br />cy.,�- <br />�—�'"!l/�a 1�i'I ii.� -,y � /hf ,c�,ut�sJ %fi6 <br />Remarks <br />Note: Original to Customer /�� ( <br />� �aPY �o F��e ;. 0 3 5 3 <br />1 Copy tol�spectar <br />_.,�;- <br />�_,Di..1: , ,. c_ <br />G cv� <br />�✓/ % � <br />�� � ��� � <br />,y,r s <br />The undersigned owner hereby agrees to hold and <br />saao harmless the City of Everett from any and all <br />claims for damages that may arise because of installa- <br />tion and maintenance of the improvement hereto <br />applied for and further agrees to remove same upon <br />notice from the Ciry and to replace public property <br />a aged thereby <br />pnature of Applicant <br />4,�}-7.(0 �'Drl-� NJ��..,��-£,--Li�a <br />Address <br />LnSr1- oB�S <br />Telephone fyumber <br />c/%InJ �, ,%l <br />Date , � �F� — <br />A <br />/1_— <br />Fee <br />Dept. App o Is <br />Engineer � �` <br />bYater n i�i�,-,-2�ef �%�,'-c�� RG/,� <br />Approved by � �/ ,6 <br />��� <br />Date Approved <br />� <br />