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_ � <br /> / . <br /> APPLICATION FOR RIGriT-OF-WAY USE PERh11T <br /> ' cvcretl <br /> ,� 10 � � � <br /> �� <br /> CITY ENGINEERS - <br /> .�� ,� / <br /> EVERETT,WASHINGTON PERMIT N0._ <br /> Tlie Undersigned C.9 nL LA,P.S�✓tJ �(Z�/7J% ���Ci <br /> Hereby applies for permission to CC;1�7 T.PC.Ie'�,T' p�/ (.�Ee..Jf� `( ' 2S�C.ii/C.r'i':i; <br /> At the following location _ i � �� ��� � ,�JG�;�3 ��(�L� " <br /> SK[TCH <br /> (Work to bc done) <br /> SEF � � �C/�!r0 <br /> l.� �a �r�Jfir��7'' <br /> � � ` <br /> f/G"�'.(�uG � /�7��..�.� Gc�i-,� � �v--�'1�1- � �� �/�1�.� <br /> 0 Go1�ic!$� �"o aa � " �-�c.0 G.Ty ��a�t.�' I <br /> � � 1 <br /> O �f�� .d y�uJ �/JJdu^� S�u/ S�G�7d7'l� 2(/i 7h� .�UJ�7M <br /> �/ y <br /> j o�n"�' ,a,��,� S�l�t/ - / <br /> � E,V� ...�.5/�h/ So�%r.'7' %� <br /> ,�� ,3 <br /> DRIVEWAY SECTION The undersigned owner hereby agrees to hold and <br /> NO SCALE save harmless the City of Everett from any and all <br /> r-- ---� claims for da� �39es that may arise because of install2• <br /> " L P tion and mainienance of the improvement hereto <br /> applied for and turther agrees to remove same upon <br /> 30'� —.�:��� notire from the City and to replace ublic property <br /> d mage thAreby. � � <br /> !tt . .�, l(_'/'.l1.P-.�� <br /> Sig w e of Applica�t�,,� L� �—��� <br /> , n_o C <br /> Address ' <br /> COPY OF THIS APPUCATION TO ������,�C/��. <br /> BE POSTED ON JOBSITE. l <br /> CALL ENGINEERING DEPT. 259-8811 Tele hone Number <br /> �,_�.�=7-7 - <br /> 24 HOURS 6EFORE CONSTRUCTIOt� Date y ^ �� <br /> 7/� � <br /> CHECK LIST Fee <br /> Wator Valvc Dept. AppfOValS <br /> Draina9e <br /> Curb&Guttcr Engineers <br /> Sidewalk Wa;er <br /> Street / <br /> Commun�ia�d�tions <br /> Inspector's Si9nature Tratfic�,ti_' J� ��� <br /> � <br /> Planning <br /> ate <br /> Remarks <br /> Nute: O��ginal to Custamcr !l <br /> 1 Copy to Filc 1 �� `i ll L <br /> 1 Copy to hupr.c�or APp�oved by <br /> Datc APPrnvcd f <br /> �-. <br />