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� i •_- <br /> APPI.ICATION FOR RIGHT•O}'•WAY USE PERMIT <br /> evcrclt <br /> � . 10 � � 0 <br /> CITY ENGINEGRS % ? <br /> EVERGTT,WnSHINGTON PERMIT N0. z � �' <br /> The Undcrsigned +�„�r ' t A " � �.a�r m A- n/ <br /> Hereby applies tor permission to /�p nic>F��� ,;T ,7 7—�� .a S!'Nfl�.T r>l .� <br /> At the following location �,�Y� YOv,r t -, _ . <br /> SKETCH <br /> (Worl: ro be done) <br /> SE� RTT�cH6r� <br /> L h' <br /> Ci� fo GDJ9Jf/ Uc� �/��� �6 <br /> Tj'Ve f�_l ��/ �-��»v�Jv � cs�G7%o?''� �: <br /> � Co�c1��"e i f /tsc�rr��� 1» <br /> rG-g" � <br /> �yii-r�� ' /y� 1�,._. � e �/,,v Q-te �u�t %�r�,...i/��. <br /> DRIVEWAY SECTION The undersigned o�vner hereby a9rees to hold and <br /> NO SCaLE save harmiess the City of Everett from�any and all <br /> f'-- "i claims tor damages that may arise because of installa� <br /> I" LIP tion and maintenance of the improvement hereto <br /> applied for and further agrees to remove same upon <br /> 30'+ .�30" notice from the City and to replace public property <br /> da e t�, ,��� , <br /> . -.! : <br /> � Si9naf ure of Applicant <br /> �i ��Z—/'i:Lc�'L.L>k/1!.'C• <br /> COPY pF THIS APPLICATION TO � Address � <br /> BC- POSTED ON J06SITE. ����. /v� 9fr� �i <br /> CALL [NGINECRING DEPT. 259�8811 Teleph ne Numbcr <br /> zsz - i6�i <br /> 24 HOURS �EFORE CONSTRUCTION� � Date �'_�_ 7 y <br /> CHECK LIST Fce �� -?_ <br /> Watar Valve Dept. Ap�rovals <br /> Draina9c S� ^ <br /> Curb& Guttcr Eo9inecrs=�����,/�( • � <br /> Sidewalk Wa(er <br /> Street <br /> �ommunications <br /> Inspeetor's Si9naturc Tret(ic <br /> Planning <br /> �tc <br /> Rema�ks <br /> Notc: Otipinal tn Cu;lomcr <br /> 1 Cupy ta PJn � : � ;� � r� ' �-- — <br /> 1 Cupy tu I;.•q��•clui � � /1Pprovcd by <br />