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everett <br /> APPLICATION FOR RIGHT-OF•WAY USE PERMIT <br />� 1n�02 <br /> � <br />' CITY ENGINEERS <br /> EVERC-TT, WASHINGTON PERMIT NO. % ' i � i �'" <br /> , The Undersi�ned �-r� �L L�j.�� �/�l �(�/l�_5T �/l�l� <br /> , Hereby applies for permission [o �lJ/(�J�T�lIC'T ��! (� ! �Y� ' ? 5 /� .• ��/�1':� ��_ . <br /> i � <br /> I <br /> , At the following location�Q� ���.f�()Ll I<-�� �'�'/�� �nl.�L-�� I <br /> � / ' <br /> ISKETCH I <br /> I (Work to be done) � <br /> I <rr i�"i r����� /-I' s`i7 , <br /> I i <br /> I I <br /> / / � <br /> �l - 5 � � cr:� <br /> �.�_.�i �,.. .�:o <br /> � ?� <br /> O�- �/r.� <br /> �. ��� . , i ,_{� ' <br /> r <br /> f <br /> a <br /> �I <br />_ I <br /> ; <br /> , <br /> j <br /> � <br /> � ORIVEwAY SECTION The undersigned owner hereby agrees to hold 2nd <br /> NO SCaLE save harmless the Ciry of Everett from any and aU . <br /> ' r--- -----� claims for damages that may arise because of instalia- . <br /> , r� +�„ ��P tion and maintenance of the improvement hei�•to , <br /> , applied for and further a9rees to remove sam�upon <br /> � 30�.1.- --------.�3�..I notice from the City and to replaceyy�lic proNerty <br /> � d, aged eby. !r�� <br /> � �i . c l�. �r.�'r��/ ' <br /> �Sign ure of ApphcanC � <br /> - --� Ad����— ��`'-�St��zdL� '�.. <br /> � COPY OF THIS APPLICATION TO �� L/ �. <br /> BE POSTED ON JOBSITE. ��, —i���ZT�� ' <br /> CALL ENGIN[ERING DEPT. 259�8811 ' Telephone umber <br /> � <br /> 24 HOURS [3C1=0RF CONSTRUCTIOtv�� Date��h�� � <br /> - - _. . . / �-c; <br /> CHECK UST Fee � ' <br /> Wacer valve Dept. Approvals <br /> Drainage � _/ . . <br /> ' Curb &Gutter Engineers l�G _ <br /> ; Sidewalk Water <br /> Street <br /> Communications <br /> Inspector's Signature Traific � <br /> Planning <br /> ate <br /> Remarks <br /> Note: Original to Customer <br /> 1 Copy to File '��q O 2 � <br /> , 7 Copy to Inspector Approved by <br /> Date Approveci <br />