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APPLf(iA1'ION FOR RIGHT-OF-WAY USE PERMIT <br /> ', � everetl _ q �•��� <br /> ' � 1 i <br /> � CITY ENGINEERS � 7 � � I <br /> EVERETT,WASHINGTON PERMITNO. / �� I <br /> I, The Undersigned -1::i`1,_' S J O��i�� i �=���l- � i r�r _ <br /> i <br /> i � <br /> ' Hereby appliesforpermission to %cNST/.'�c T� .:� __�.�,'��-1<nr�ra�r/� ��,�.i -- I <br /> ! Atthefollowinglocation .Sf/2 � /LU/�� J � %l,i� i <br /> � SKETCH I <br /> i (Work to be done) � �� <br /> i' S F/� /�""�!'11;14�c?. ' I <br /> � <br /> �i <br /> � I <br /> i <br /> i <br /> � � � <br /> i i <br /> , '� I <br /> � i <br /> 1 I <br /> i II <br /> I � <br /> I <br /> � `- <br /> i �• , � <br /> � <br /> � � �� <br /> � � — � � <br /> �,I , ` � + <br /> , / , <br /> � � <br /> � � "�, I <br /> i _ <br /> � <br /> � <br /> li � �� \ DRIVEWAY SECTION ��y'� The undersigned owner hereby agrees to hold and <br /> � NO s'CaLE � save harmless the City o�Everett from any and all <br /> I �•-- ----I claims for damages that may arise because of installa- , <br /> i r\ �„ ��P —�� tion and maintenance o+the improvement hereto � <br /> ��— appl�ed for and further agrees to remove same upon <br /> '�� I 3n�� I �-___ I 30'� notice from the City and to replace pub ic property � <br /> � �� � � —� � age ereby. " -��� I <br /> ��/ I <br /> i ��� ' ure of Applicant <br /> �—�--- �. e l- � G�-- L o S�� <br /> ; -'�I COFN.DF ?HIS APPI_ICATION TO . AdJ�cess � <br /> �i i QE P � TEO�ON JCtSSI?[. '"�``J ��� r�� � <br /> j � � Cr\LL NGINEER�N3 DE�T. 25&8811 TelepJ�ione Number ', <br /> > �S—d � � �/ _ <br /> � 24 HO flS 6EFORE COPISTRUC��ION Date S� �j . <br /> CHEC LIST--------- ---- Fee � 2 1��.�47 . <br /> Water Valve Dept. Approvals !, <br /> reinage i <br /> � urb&Gutter Eingineers �, <br /> '� Sidewal - �Nater �'� <br /> i <br /> �, Street_ _ �� <br /> i <br /> Ccmmunications ___ i <br /> � Inspector' Signature � �. <br /> Traffic <br /> I <br /> '� . � � Planning - <br /> .- a�te �,�` � <br /> I <br /> j - i <br /> I <br /> �� Remarks �I � <br /> ��. Note: Original to Cusromer q �y �� <br /> ���, 1 CoPY to File �-- I. C�7 C Z I <br /> 1 Copy to Inspector Approved by . <br /> ' Date Approved � - <br /> "+c:�: <br />