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APPLICATION FOR R1�4iT•OF-WAY USE PERMIT <br /> �.,«<n 10� a i . <br /> � Q �'� <br /> CITY ENGINEERS � Q�J <br /> EVERETT, WASHINGTON PERMIT NO. �� <br /> The Undersigned lUr�o�J NJ] C� T%� `�L� �7 �.�,� ' � � <br /> � Herr.by applies tor permission to_ �ONST�U�T 2 - Z9 � � �/'i��G% /�� �S � <br /> At the following location .�� y (�E������ /¢y <br /> SKETCH <br /> ' (Woik to be done) / � <br /> I <br /> I/J I <br /> CoyC � ',� <br /> `:. �\ 90� <br /> -V i \ `'o' <br /> �o Sc.� �1�� I ^'s,�, z X4 CEo�+2 Cu,�g <br /> <£ ,�, <br /> � � � <br /> �� `� °�Y. <br /> ��� 8,�-/ 9 <br /> V� A��9ti <br /> (�� '✓ a V <br /> '(/ ��`� �9yi <br /> Q@. `G-� <br /> ,�9 <br /> /' � � � <br /> " . � I <br /> i • . Zx4 c � 5}i. GuKiS <br /> DRIVEWAY SEC710n1 The undersigned owner hereby agrees to hoid and <br /> NO S�aLE save hermless the City af Everett from any and all <br /> �y_ Z C� � - ---I claims for damages that may arise because of installa� <br /> �I�� LIP � ��-�};� ! tion and maintenance of the improvement hereto <br /> � 30' applied for and further agrees to remove same upon <br /> 3�'�_ T—.�.—�.� naf from �e Ciry and to replace public properry <br /> Z�' d/a/ ed tf by. ,� <br /> --- - $'.� ure�Applica�� ��^/ <br /> Ltl c:� <br /> COPY OF THIS APPLICATION TO ,p�U�• G/ A�I ��� 3— O I <br /> BE POSTED ON JOBSITE. � � � <br /> CALL ENGINEERING DEPT. 259�8871 �',� Telephone Number � <br /> Z�: HOUf?5 BEFORE CONSTRUCTIOPJ � Date <br /> - _ ---- -� ����/7=• 2 �/a a %G� 5 / /_ <br /> CHECK LIST Fe�e <br /> Wator Valve t. Ap rovals <br /> Drainage 6 z_7 <br /> Curb&Gutter Engineers f��'G'� � <br /> Sidewalk Water �/` '�;S <br /> ' ' �� � Street <br /> / / /i <br /> �! : /l (_'-l.% Communications • � sr_.es - G - �� 7�' <br /> Inspector's Signamre " ��� <br /> Traffic � �%' � 11 <br /> _' - Planning:� � � � lCG- � ✓ �7�^ <br /> �� ` ,y /i � /�,: <br /> -Date � - <br /> Remarks <br /> Note: Original to Customer <br /> 1 Copy to File �O�O7 / <br /> 1 Cnpy to Inspecror App o � � � � _ ;� � <br /> �. /t`>;-�i_..... ✓ r=' i—�� <br /> Dote Approved <br />