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APPLICATION FOR RIGHT-OF-WAY USE PERMIT � I <br /> everett 1�3 51 �i�jf�/„/',f' <br /> / �(�� � <br /> � � � �(�'G���'3 �� <br /> CITYEIJGINEERS PERMITNO. � '-�' �� <br /> EVERETT,WASHINGTON ' <br /> � <br /> ' �-'� ,` -`-: ^�,Y_--�� .. <br /> The Undersigned !�'� 'L' - , �, <br /> !i . ..` i .�. � 1 .) ..-�r.. ;�.-.'o c % �.0�•��' - <br /> , Hereby applies for permission to <br /> .� At the followin9location � � ��i = (_��..�:`%�':i 7,Lr�/ !/�" . <br /> � SKETCH <br /> � (Work to be done) '. <br /> - �'X; :�,i �/,_/;, G ,� �✓Z ;�'�`=,•c'i ¢ I <br /> � �'� <br /> I � � <br /> � � � __�.�— — I <br /> , i�, � — <br /> li <br /> I <br /> 1 �� _G✓� �/� f�' <br /> ll� � „� _;���.� <br /> 4 `-- ` ��ii� <br /> Ir � � � <br /> ���� , ��.=� S �� <br /> .� � � ��,� <br /> � �, � ��:;v�= <br /> � �, <br /> � ' � <br /> i fi ` \' _- � <br /> �� ' , _ ; � <br /> , ��- �y✓5 Tr.i.,, ; ;-)_::;:��.;�1� �I <br /> � ' <br /> � � T�', I�cWr=' �� , <br /> ', � � li <br /> ,, , <br /> � <br /> �� � <br /> � , ., ' <br /> � � DRIVEWAY SECTION ' The undersigned owner hereby agrees to hold and <br /> NO SCALE ,/ save harmless the City of Everett from any and all j <br /> �__ `c� --•{ .f �j� claims for damages that may arise because of installa- � <br /> , ��/'� � ��.�' tion and maintenance of the improvement hereto I <br /> Y' LIP y applied for and further agrees to remove same upon � <br /> �� 30' 30�� l.• � " no ' ro the Ciry and to replace public property I <br /> � � � �' ��' e a d er � <br /> ! � <br /> '� ignature pp icant �1 ��L( . <br /> /ni li7 Q 7'�' /'n// ��" ' _ � <br /> � COPY OF THIS APPLICATION TO " � d3e>(s_v�JJ41 (� 'I <br /> ' 9E POSTED ON JOBSITE. Telephone Number ', <br /> �' CALL ENGINEERING DEPT. 259-8811 � '- 7� .�'-�- i <br /> 24 HOURS BEFOR[ CONSI'RUCTION' Date // i <br /> �- ---- - -- - - - -' 4 / �i�� �1 . �z 1 ,{' y r0 <br /> '� CHECK LIST Fee . I <br /> Water Valve t. p o�ls � <br /> '. Drainage � j <br /> Engineer <br /> ' Curb&Gutter Water b� per �P e I��' c �.�TQT I <br /> ' Sidewalk nF;�q . � <br /> � `� "-� �- Street��`� � I <br /> ' Communic ns .'� '���'=�'-�"'`�' - � �-�6 ' <br /> n pec or's Signature • Traffic �I <br /> ' Planning i '-. � � � �� I <br /> � � Z- l6 — G� cr� � - ' _— <br /> r � �uJ-.,�.a.s_o„ <br /> ate I <br /> �, . �. <br /> � <br /> ' ,ti�� �� c eL.. . � �c� /Ja._. �� <br /> � Remarks .� . <br /> � Note: Original to Customer � <br /> � 1 Copy to File �0 3 51 Approved by � <br /> , 1 Copy to Inspector '2�_3 7,6 <br /> Date Approved <br /> -ci. .�.,.: <br />