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<br /> APPLICATION FOR RIGHT-OF-WAY USE PERMIT '
<br /> ev�
<br /> 10595 �
<br /> CITY ENGINEERS '' �� i
<br /> EVERETT,WASHINGTON PERMITNO.'�J�+ "��� I
<br /> j TneUndersigned�r/F„� � � /-iic„
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<br /> �. Herebyappliesforpermissionto�Lr�15}�v�l 7 /%� /�cc�i�/f �7y� C-i.��1c,
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<br /> � At the following location �/�' -''J f n�e_;!" J>ri v�'
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<br /> SKETCH I
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<br /> �'�, DRIVEWAv SECTION The undersigned owner hereby agrees to hoid and �
<br /> �, NO SCaLE save harmless the City of Everett from any and alI �
<br /> � �— �--"� claims for damages that may arise because of installa- '�,
<br /> �`��� ��p tion and maintenance of the improvemen[hereto I
<br /> � applied for and further agrees to remove same upon i
<br /> i, �-30+�--- —►�•;�-� notice from the City and to replace jublic property �'
<br /> ', da therebyf� ' � f 7v •d/ Lu�l. Artd'/, I .
<br /> ' Si at r o Applicant '
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<br /> ' COPY OF THIS APPLICATION TO � Address ,
<br /> �, �E POST'cD ON JOBSITE. �l 3I"-� 4 I�t 9' - .� S 3 -o /G d '
<br /> . Teiephnne Number �,
<br /> '� CALL EPdGINEERING DEPT. 259�8871 �Z,�J�
<br /> � 24 HOURS 6EFORE CONSTRUCTION Date � '
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<br /> ' CHECK LIST Fee ' j
<br /> Water Valve De t. A
<br /> p pprovals
<br /> '�� Drainage ,; .�1 . : q ; � '.
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<br /> Curb&Gutter Engineeprs ' -� + �� �.,� .- / �: '
<br /> Sidewalk Waterl7. �4�i �f/yeei-se',� ,C-S.�13. �
<br /> Street ��� �, .__ � � � / �
<br /> __ Communications���,/"�y ����.va��Ky�✓, ��,
<br /> . Inspector's Signatvie ' '
<br /> Traftic
<br /> �. / Plannina �� -1,f�� ��i��,�i7v — �
<br /> � ate �S, �{/fP d, ��ae.vBr, /✓,C; �/,.�J 5.+�, /.�� �
<br /> i�d i
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<br />� � Remarks 'i
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<br /> � Note: Original to Cusiomer �
<br /> i 1 Copy to File �O 5 9 5 .
<br /> 1 Copy to Inspector �,_,_APP� ed Y -. � �
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<br /> � Dat� Appr'ved� '
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