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` �errn ' APPLICATION FOA 71GHT�OF-WAY USE PERM17 �,�,23(F <br /> _ � / .,/ . <br /> \� _ <br /> CITY ENGINEERS <br /> EVERETT, WASHINGTON P[RMIT NO. 7�'-/ t O <br /> The Undersigned =�a�-�- C-�•����LJL� �� ' <br /> NerebyappliesForpermissionto \� ':>'�"ti�-�.`. Z ��L �J�"�-� ��`y � C ?�a \ � 3S� . <br /> '- O� � c <br /> Atthefollowinc�location_ AT I��'i�t_Ox- �=—"�� GJ �...`Y`4CL�. 1J �la�( � <br /> SKETCH <br /> (Work to be dona) �.,(o,,,�(� <br /> W�c�o-,�r� � Cu. 6� yv�uCu�. a," clya�•---y av� pvb��c �1'- � 3l,��lil �a rOKS'ar . <br /> i-. 4 «c .siL�.-�-c_ ti. -✓� d-e �. f�.._..!`a.'� pl , . <br /> 's-3o -)e- <br /> .Jv,s� �. � <br /> � �itli /�/�/N�' �F�.r' �'�/lr!� �� �f�l9r%Lf' �dL.C.l��il <br /> �":l.�r7lh� TA�3,G!l.ti`.�`it� �/'.P+F7J /�l.r��l.'/•��1? /�C/ 7�i�l.t' <br /> ��.�lE./�.. <br /> �� ��� <br /> �/ �u-�-cl,` �feC� ��lp �C��S <br /> x. .; <br /> , <br /> ' , <br /> �i,. <br /> DarvEWAY SEC7tOnl The undersigned owner hereby agrees to hold and <br /> NO SCALE save harmless the City of Evere[t trom any and all � <br /> � —"'I claims for damages that may arise because of installr � <br /> i" �ip tion and maintenance of the improvement hereto <br /> applied for and further agrees to remove same upon <br /> 30" 30" no 'ce from the 6iEy and to re lace puhlic properry � <br /> \ma9 d.t�b� . � . <br /> � � <br /> . Sipnature of Applicant <br /> �A�ci� S �. ��� `(��.'1.�.��G `l�uu�� � <br /> COPY OF THIS APPI_ICATION TO � Address � <br /> BE POSTED ON JOBSITE. _l 4-1 - d,2S� �� <br /> Telepho ie Number � <br /> CALL E�JGINEERING DEPT.259-6617 ,c,'� .ZZ11� . <br /> • 24 HOURS DEFORE CONSTRUCTION Date <br /> ,, ,. , <br /> CHECK LIST ' Fee <br /> . z,� <br /> Water Valve ,4-; J;�. � <br /> Dreinage �*� �` ` : Dept. ApproVals <br /> Curb &Gutter r w��� -�. �-��� ` " Engineers <br /> Sidewalk ..,. ;, '..�� ctt*r.;. ;i - ,. <br /> - °x' -�� Warer <br /> �� � :�.� Strcet ' <br /> .p�, Communications �. <br /> . Inspec!or's Si9nature Traffic � <br /> , � � � � Planning_ � <br /> ate <br /> Remarks � 1 �� � , <br /> 1. <br /> , APProved by <br /> . � <br /> . ._.-::.t1s'-1..>r_ . ..... ..'. CUlTOME7l IlataAnnrnvrl 9 . <br />