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p <br />everen <br />e <br />CITY ENGINEERS <br />EVERETf, WASHII <br />r <br />The Undersigned _ <br />Hereby applies for p <br />APPLICATION FOR RIGFIT-OF-WAY USE PERMIT <br />r <br />� <br />SO �n��rurY 29 (Gn!'/C�P ��W <br />At the follo�,ving loca[ion 33 2A r ��/f rn l A v(' <br />(Wark to be done) <br />�� ' <br />sm� C'x,� F�� u�4.� S�,�G� <br />To �BE •4wv.sr�i� iF �T /s W� n�i.v <br />Ti�j�� /✓EG% ��:/vr.L[1+4��....�., by <br />r � <br />� �'�Ltd_�_„e,,. <br />3- »-�� <br />ORIVEWAY SECTION <br />NO SCALE <br />f.-- 2q' -�i7 <br />+I" LIP � / � <br />30" _�30"J <br />�COPY OF THIS APPLICATION TO 1 <br />BE POSTED ON JOBSITE. ! <br />�CALL ENGWEERING DEPT.25&II817 �'� <br />24 HOURS BEFORE CO�J�TRUCTIOMJ <br />--- --- -- ---- - -- ---- <br />CHECK LIST <br />Water Valve <br />Drainage <br />Curb & Gutter <br />Sidewalk <br />_\ <br />Inspectar's Signature <br />Remarks <br />. Note: OriginaFtoCustomer <br />,,:aPY ta �,�� 7. 0 411 <br />��, 1 Copy to inspector <br />46:;:� <br />PERMIT <br />10411 ��� <br />, ��. -_: ��S <br />� <br />-- � i,V _� <br />_-_'_._—__..._Cooslrufrt ConC <br />O/W —i <br />a <br />The undersigned owner hereby agrees to hold and <br />save 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 City and to replace public property <br />damaged thereby. <br />/,.. 7%. a ��1�1 �Z ' <br />Sgnature o�plicant � <br />� /�.. ��_..(.. <br />A dre�l s( <br />/1 � �� %/.��C�J <br />Telephone NumlSer <br />/) d�Z..���o� ��� / �7r <br />Date <br />�� /, ' . �V � ���T <br />Fee � <br />.. �:r�'��/%�' _ <br />� -- <br />�.••.. � <br />