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APPLICATION FOR RIGHT•OF-WAY USE PERMIT 10212 <br /> evercri <br /> � � �� <br /> ITY ENGINEERS PERMIT N0. " , <br /> EVERETT,WASHINGTON ' <br /> _��l-1,E S ,�AuJ l��ti.So�v j <br /> The Undersigned /� � ,� /� ��� n,�f (���'��.p�C�1 -, <br /> - Hereby applies for permission to t...D,{�...$'r"IC�(1G t � LY ) ', <br /> �r i <br /> I <br /> — 2c�2 _ o �ST � ; <br /> At the following location - <br /> SKETCH <br /> (Work to br done) . <br /> �� x i <br /> � �. a as �, <br /> . (nc -1 � 9x � <br /> . �� L NJ 1 � �� <br /> m c; N s. r. �- <br /> N l� c N+ �r Z �+ � <br /> � C ��' \ � i`'l" � <br /> � � � � <br /> � t � <br /> a N i <br /> � � J�/o SC A L L �I <br /> �n i <br /> �oR T V�c i nt�(yL,f 3 <br /> �� <br /> �d <br /> � , <br /> No7'E : A btii/���.��-•��1` �r a. �— <br /> f-�xc.� L�.s issued //- Z7-73. <br /> ' /9 S �a�����eiz-cL of Go�rG�'�fe �o c�S <br /> ' �!'oH fi. �/��-�j �v�EST V/-euJ.�i2 �t rc t( <br /> �GYG(�c (�/�uJ�vc{� Wlc..e/"P� ���-P�%��P�GQJ I <br /> r�vz.// s7a�'cdn,/� ��� s ���sid/-e /�z[i' �,/AY �f w�, � <br /> , �/�t� Srt.Ou.`A !�-e. w /-/qLt,��hY��(Se.�rIGC� .. <br /> � DRNEWAY SECTION <br /> �� � �H�L�The undersigned owner hereby agrees lo hoid and <br /> � NO SCaLE � _�,7� save harmless the CitY of Everett irom any and ail <br /> � � ��„L--_.__.! claims for damages that may arise because of installa- <br /> 7 � tion and maintenance of the improvement hereto <br /> I�� LIP ��/��,�/1f (-��/ appiied for and further agrees to remove same upon <br /> �, �30 __�'�J•}--- -�30"�,I y-�� � notice from the City and to replace public properry <br /> -��-- 4-/lL damaged there6y. ,;:%� <br /> i ���I R� � i.�� -1 ��.t�'`'`ti"'"��'�� �, <br /> Jr_ �7- 7.% Signature of Applicant , .{� �j_ , � <br /> ��; 5' ��.�/1- � ,_ ,rr�zi <br /> � �"d�as ��, - � <br /> �COPY�F TtiIS APPLICATION TO �p �,,�,�`' �,!/,� � � -� �✓ . <br /> . BE POSTED ON JOBSITE. Telephone Number <br /> CF1lLEP'.GWEERINGDEPT. 259�8811 '��� - 7l 7� <br /> � ^�; II�,�UI�,S GFFOR[ CONSTRUCTION Date � � '. <br /> � - - - --� �� /�4p� /!' .. . <br /> CHECK LIST Fee � �••7"'u 'f'68'E �' b �� <br /> Water Valve . c� '� 3� �D t. A provals <br /> J�:} <br /> Draina9e � Engineer �`� `v��� ' ' -�`S <br /> Curb&Gutter � S'�,9-7S <br /> Sidewalk � Water � <br /> `3-� ' � �� Street �� <br /> � �� Communicatio �� "`'�� �� 's' � ��7-�'' <br /> r r <br /> _ r.�_ 'i l: � ,i �" d- � . <br /> Traffic �, - � � <br /> Incpecto��fiignature ' i � <br /> ,- :.. -7 Plannii�g 71 <br /> � ,. - . J� ' � � _ — <br /> ate _ <br /> Remarks <br /> Note: Original to Customer 1 n��� <br /> t CoPY to File �i ApProved��, Q�.�i. JYGJ��.•'�•.�-'C, �"�-��^ <br /> 1 Copy to Inspector N ��� <br /> Datc Approve <br /> ..- <br /> _-, <br />