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. APPLICATION FOR RIGHT•OF•WAY USE PERMIT <br /> evcrMT - - �U O 3 ? <br /> e _ �� <br /> CITY ENGINEERS 74- �j I <br /> EVERETT,WASHINGTON PERMIT N0. <br /> � The Undersigned el'� �-��v% `�n�? <br /> '� Hereby applies for permission to C--O/�'ri 7f�l 1�..T R Z�r Cn�C �/�� � <br /> At the followinc�location S ( ( "t' ��L'�l-�e �V�� �� <br /> SKETCH II <br /> ��, (Work to be done) '�. <br /> ', uo S��E 5//� <br /> ; <br /> -- -- �a� s. <br /> ; , <br /> ;� ,� � <br /> EX�ST�ti/l1 cvlli3� //� __ <br /> � ��, � : <br /> �Oc',�/�J ,c�wLE� �v� <br /> �I �— <br /> DRIVEWAY SEC710N The undersigned owner hereby agrees to hold and ' <br /> NO SCnLE save harmless the City of Everet[from any and all <br /> � � -� claims tor damages that may arise because oi installa• <br /> � <br /> tion and maintenance of the improvement hereto <br /> f' LIP [�� y 1 applied tor and further agrees to remove same upon <br /> 30'�„___ —_..4.3���.� notice from the City and to replace pubiic property <br /> damaged there y. � <br /> 1 � <br /> G � Signat re o` p lic� ��jZy��(�.; <br /> _ _ � �� 9�i7 00� <br /> COPY OF THIS APPLICATION TO Address , <br /> 8@ POSTED ON JOBSITE. ��� ` ���� - <br /> ` / /�' Telephone Numher <br /> CALL ENGINEERING DEPT. 259�8811 �/'�� /'. .v - ` 7 ' <br /> v � <br /> Date �ci/U - 2/-7 <br /> "'� IiOURS L'EFORE CONSTRUCTION I . �� //S� ���k��7 , <br /> U�� ---� <br /> CHECK LIST F� T >/ <br /> Waier valve Dept. Approvals �r ` <br /> � Draina9e � ' � � , <br /> Curb&Gut[er Engineers � <br /> Sidewalk Warer�__� �'A"'�'� � <br /> . Street --�- � ' " <br /> ��J '��^ C�?����' � �� Communic t' � <br /> � Inspector's Signature � r� - � �, ,� ' Traffic <br /> L ��G ` � � � � cL <br /> . ��'++ Planning <br /> -/ Z ' �� <br /> �te <br /> i <br /> Remarks <br /> Note: Original to Customer � <br /> 1 Copy [o Filc , �O 3 2 Approved b <br /> � 1 Copy to Inspector <br /> Date pproved � <br /> ����� <br />