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� everett <br /> APPLICATION FOti RIGHT•OFWAY USE ?ERMIT <br /> � � 10956 � <br /> I <br /> CITV ENGINEERS � ,� � , <br /> EVERETT,WASHI�JGTON PERMITNO. �i ". L <br /> -> �- i <br /> TheUndersigned_ �'ar.�l ./,zf.i�": <br /> Hereby applies for permission to (�� �'/�.7,i�,�_� - �-1 _i c � L'.� �•. �., � ��� 1)/ ,.i <br /> � — � <br /> i <br /> At the following location fi��i '7 � !:�� ;� .� �7.� i -: I <br /> I <br /> SKETCH ; <br /> (Work to be done) <br /> I �.',_ A;;ri�i��G,7 i <br /> � <br /> I <br /> i I <br /> � <br /> . i <br /> i <br /> i � <br /> � � <br /> i _ , <br /> ��, . r. i <br /> i <br /> I <br /> I - <br /> � ' <br /> , _ <br /> DRIVEwAY SEC7ION The unders�igned owner hereby agrees to hold and <br /> . NO SCa�E save harmless the Ciry of Everett from any and a�l � <br /> ��, � ---� claims for damages that may arise because of installa� <br /> � �� �I" LIP 1 tion and maintenance of thx improvement hereto � <br /> applied.tor and further agrees to remove sam=upon � <br /> I �o'yf�____ 30" notice ftom�e City.and to replace public properry <br /> �'_ <br /> damagetl thareby. � <br /> t <br /> Signature of Applicant <br /> -- -_.. _-�-- - � / �' i ,.�. '. . '. . <br /> , ' COP1' OF THIS APPJCA�I�ION TO � Address ��X. � �,y- � � <br /> � BE POSTED ON JOBSITE. � -� � <br /> r <br /> CALL E�GINFERING DEPT 259�8871 Telephone Number . <br /> ' 24 HOUHS 6FFOR[ CONSTRUCTIONI Date ' <br /> . _ . . _ _. . _ _ _ - '_ .. _. _' ;-Li <br /> / / <br /> � CHECK LIST Fee <br /> � Water Valve <br /> Drainage ' �pt. Approvals <br /> Curb &Gutter Engineers � � � , � � " <br /> � Sidewalk � . �� � <br /> . � . . Nluter <br /> Street <br /> . Communications . <br /> Inspector's SignaW re �� <br /> Tratfic <br /> Planning <br /> ate <br /> Hemarks � - Y <br /> Note: Original to Customer � <br /> 1 Couy to File � ��j 5 � - . <br /> 1 Cony to Inspector Approved by '� <br /> I � <br /> Date Approved � <br />