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I <br /> APPLICATION FOR RIGHT-OF-WAY USE PERMIT 112 21 <br /> �ERS <br /> „WASHiNGTON PERMIT N0. 7 � `�2 Z <br /> ,undersigned �Al�(7 W SCk11�EI�E2 `c�. �OCFQ C Q/�-�'}J_(,jt,(,Y <br /> Hereby applies for permission to O I ST2�S�t i �121 V ELt1A`/ <br /> ,�ni� <br /> At the following location� FA�I b�F`/ <br /> 9 � s � -� � <br /> SKETCH <br /> (Worktobedonel C���p��-e ��� G � V'���.. �1.t1L-v� <br /> JS�i <br /> � � � <br /> I <br /> � , <br /> �D-�� . <br /> nw �;-.w'�Y <br /> � ,�+� �o � l.l��C���� �q�1 <br /> ��,� �g-r(ZuCT� d� "-Y���6� <br /> � � IN�� �� L���C <br /> � , u ���v� <br /> - �� s�UG �"�-K- <br /> ���� ��i q-v E, �� s�.r� a� �. <br /> � <br /> . ; <br /> � DRIVEWAY SECT�ON � � The undersigned owner hereby agrees to hold and �I <br /> NO SCALE � sa�e harmlets the City of Everett from any and all � <br /> �-- f----� claims for damages that may arise because o!installa- � <br /> � i�., ��P— tiun and maintenance of the improvement hereto i <br /> LDO",4„ �—�/,� ( . _I"30'� applied(or and furtlier agrees to remo�•^same upon <br /> r ---r_� � noti �o the Ciry and��'T�place public property <br /> ama here� / J � <br /> ( � <br /> . Sig ur of Applicant <br /> . D. l 3 ,EdEiC���Zo6 <br /> �rOPY OF THIS APPLICATION TQ � � Address , <br /> cFPOSTEDON.lO85lTE. `�� ����1 <br /> Telepho�r��e� <br /> CAILENGINEERINGDEPT.25g881t � / <br /> Z4 HOURS BEFORE CONSTRUC?lON ; , " . " �" �. Date <br /> CHECf: LIST Fee <br /> Water Valve ' ' Dept. Approv�ls <br /> Drainage <br /> Curb&Gutter Engineers <br /> Sidewalk ' Wxter <br /> Streat <br /> ' Communitations <br /> Inspector's Signature Traffic <br /> Planning <br /> ate <br /> Remarks 112 21 <br /> APProved hy <br /> ,L ; ' �,� f <br /> �,I� ' GUS7oMER Date AppinveJ �. .�r1•"� (�� �'.� . <br /> 9\/h`ln <br />