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APPLICATION FOR RIGHT-OFWAY USE PERMIT <br /> evcrett 1 1�8 5 I <br /> � <br /> CITY ENGINEERS 7� <br /> EVERETT,WASHINGTON PERMIT N0, �3� <br /> i The Undersigned S/� � ��-'/ ! �1.1 �;i��) � ' � � < <� • ' � — <br /> . �I <br /> 'I Hereby applies tor permission ro -��� ���"' �— -�-� l ~ �Si�lf`�� i � � <br /> i <br /> � � � ,�� i <br /> , At the fnllowing loca[ion y `1/O � �V JL � '— <br /> SKETCH <br /> I (Vbrk [o be done) . � . <br /> ..'�' ,'1T�,a.. �t ',> �� <br /> i � <br /> ' `i <br /> il �� � <br /> ; <br /> . �' <br /> � �li <br /> I <br /> I <br /> I � � <br /> � <br /> '�' <br /> � <br /> , �, <br /> i <br /> ' OttrvEWaY SECTION The undersi9ned owner hereby a�rees m hold and <br /> ' NO SCALE save harmiess the City of Everett irom any and atl � <br /> '� iT __—_—J clairas for damages that may arise because of installa- � <br /> � tion and maintenance of the improvement hereto � I, <br /> L� �i" l iP applied for and further agrees to remove same upon ' <br /> , 3� I l-- _ _ I 30" no:ice fro t e Ciry and to replace public roperry <br /> �- -�"- ------- 't' demage � bY. ' <br /> i , c� ✓� <br /> ' `�Si9nature of App icant � <br /> i <br /> COPYOFlN15 ,\PPLICP.TIC',1TU . ..�, A�5 �n ff�' ����� <br /> BE POSTED 7h JOBSITE. Te�hone umbe� <br /> CAIL ENGIN"ERING DEPT. 259�9811 II ,���5-.�.�'�5�� <br /> �� 4 H iiR� Ff���E COI�STftUCT!OMI Date /� <br /> ? n _ g " .'_.. _ _.�' _ , �nl � � �� � ��, <br /> CHECK LIST Fee �2 S <br /> N�ater Valve Dept. Approvals <br /> � �Drainage Engineers� ����� <br /> '� Curb ey Gutter ' <br /> Sidewalk Water <br /> Street <br /> � - Communications � <br /> , Inspector's Signature Traffic <br /> Planning �, <br /> �ate <br /> Remarks <br /> Note: Original to Customer 1���5 <br /> 1 Copy to File Approved b7 <br /> 1 Copy to lospector <br /> Date Appraved <br />. ' ti \rLL�ZL� <br />