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;.� . <br /> APPLICATION FOR RIGHT-OF•WAY USE PERMIT <br /> evcrett �0 �n �n /� <br /> � 4 J �.�/ <br /> � j _ 3��`� <br /> CITY ENGINEERS , <br /> EVERETT, WASFIINGTON PERMIT N0. r�� '-��—' <br /> 9 - L . / --c- .—�',,�=; �L_ � <br /> The Undersi ned �-��,��� l/Y G_� :� t _ � <br /> �� <br /> Hereby applies for pertnisiion to /NSTi'-�GG... �`2 C�i[._✓Ei�T <br /> �� At thr following location ���+� �-����T �%�f=�N ����l��` ' <br /> SKETCH <br /> ' (Work to be done) � 1 '� <br /> \'{ �i <br /> �' �� � � I <br /> . f _. ..... _. i . _ . _ . rl .1v � <br /> �� I I ( ` � <br /> ✓� � I � <br /> � � i,Us-�iL '2 ' �^�i' vE�� <br /> � <br /> L I <br /> � ��_1 �i <br /> n � <br /> ' ��i 39 I � 'i i i <br /> � ' � <br /> � � I <br /> ' —.r;:r �_�., \1 I <br /> � - \\ <br /> . . � ' :'IiC.M" C '� � . <br /> � _ ,f:� __ � i V <br /> I � r..' <br /> i �� � <br /> � -�o' ���i <br /> �� EXi si�n�G Z3 ' c�,uc, :��i�%� � � � <br /> ' iz � Cv� vE��, --�',r, �•; 7�:--%_;: � 1�� �I <br /> � � <br /> f u' - .; -- � ..��.�.-� � <br /> , � � ��� � .� : � <br /> ad�� a '° h <br /> f� �/o " ` ` � <br /> � ,,:�., . '�- <br /> i �yt'�tyy�� DttivEWAv SECTiON �� Thr undersigned owner hereby agrees to huld and � <br /> NO SCaLE /�� save harmless the City of Everett from any ard all <br /> r-- Z3� ----� 1��\lr claims tor damages that may arise because ot installa� � <br />'' � � tion and maintenance of the improvement hereto <br /> � I" LIP �)��/ �� n� applied for and further agrees to remnve samc upon <br /> . 3p � __ I 30 1� � <br /> — �. J l �� �� notice from the Ciry and to replace pubiic property <br />� �� dama�ged lherehy. � �� <br /> � N _(,i: t � �I�rii.�v: a�, . �:L I <br /> i �� Siynature of Applicant ° . , <br /> S;!� G ';', . <br /> COPY OF THIS APPLICATION TO Address <br /> � BE POSTED ON J06SIT[. �^-'-'� �- ' �' � � <br /> �� Telephone NumLer � <br /> � CALL ENGINE[RING DEPT. 259�SB71 �;�.�,. � %�_�� I <br /> . 24 HOURS BEFORE CONSTRUCiION Date ' <br /> ----� -- ------_.__. <br />�� ��i ,.:_�.c- - �I <br /> I CHECK LIST • Fee - <br />` Water Valve D pt. A prowls <br /> ; Drainage � <br /> I Curb&Gutter `? Engine <br /> Sidewalk ��;J�� Water q �fE'�- �i�u�ss ✓� �G� . <br /> � • � Street�'��-�� ��_� <br /> � �� � Communications_ ' <br /> � <br /> I I " ec[or's Signamre Traffic_ �! _,e <br /> I I .7 _ I S - 7 � Planning �� � yL (� <br /> . 'f <br /> I I, ate / ���'r..rr /V C'. ��ro �J,o s�•r Rl�'.+�� <br /> . �i4't.�it-'\ FY-t'� V I��f I d'I.V�.�h.-- i <br />, I Remarks � �', <br /> Note: Original to Customer � <br />� 1 Copy to File 10409 � <br /> � 1 Copy to Inspector Approved by � <br />' Dale ppr� 2 <br /> ��c <br />