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J <br /> everen APPLICATION FOR PIGHT-OF-WAY USE PERMIT <br /> � 10259 , <br /> � i <br /> CITY ENGINEERS <br /> EVERETT, WASHINGTON PERMIT NO._�� — �.�� <br /> � TneUnueisiyneti 1_ F Mras T(� I�� ��t��l �)�._f{,1 �nli�. � I <br /> �� Hereby applies for permission to _ L.,G'JS T�ll T /y .J r1 � �� ` �� ,/� r_ 1►R�UG � V , � <br /> i At the followinp location � �� )�� �' i��_ T (�P� ('?V�, i <br /> � <br /> L07 /l-/� C;LI� L' I� �. ��� � � <br /> I SKETCH <br /> I (Work to be done) i <br /> �� � �� <br /> i <br /> I ---- � <br /> I 40� <br /> i <br /> � <br /> i 2�'30 I �'R ��� , <br /> I P lJ I i <br /> i �.l `� <br /> � ! <br /> i 23 ' . <br /> I + g � T <br /> � � J � � <br /> � ; �� <br /> � <br /> � ,\\ j ' <br /> \ �� � � <br /> Nr Jl ;-�� PN'�L I / 'I <br /> � D1; i Vt� UTA'�— � <br /> ���s�r�rc c�i,�t, r�u;� � <br /> , <br /> — r;urre i� � <br /> �� � I <br /> �,, ORIVEWaY SEC7i0N The undersigned owner hereby agrees to hn�d and � <br /> i NO SCALE '� save harmless the Cily of Everatt from any and all <br /> � � -� � claims tor dama9es that may arise because of installa- , <br /> � f' LIP tion and mainrenance of the improvement hereto � <br /> _�� applied for and further agrees t/� �emove same upon <br /> �, 4„30'�__ �7�' __ 30' notice om the Ciry and to r place public property ' <br /> i da g �he y, -� � �, <br /> ��'1�;. t� t' LU �:I ,(�I. � �' � • - G�' � <br /> ign�atupre of icant n n <br /> ' COPY OF THIS APPLICATION TO 8 I l ?� Addre s' / �/ � X�J��� ' <br /> ' BE POSTED ON JOBSITE. ?'35!' } C��G ,Q/.a„c��-.,.� 3s'y-�f ''� <br /> �, CALL ENGIfVEERING DEPT. 259�£381 I � Telephone Number , <br /> � 24 fiOURS FEFOR[_CONSTRUCTIONI� Date � . n , <br /> I CHECK LIST � / J �n .,� ��i {•-���._��J <br /> ��\ .. Fee � <br /> Water Valve i ��, � <br /> . Drainage � qPt Appfbvals <br /> �. Curb& Gutter � Engineers -�'`'r'-'�`�� ����5 <br /> � Sidewalk . � <br /> ' �i .-� � 'i . Water_ � — / G" <br /> � <br /> � 5[reet '�:' <br /> .'��.! � � -" � <br /> /����� Communicati rss"���• - .�-.� � �"�?- �'"- <br /> Inspector'sSignaWre � / � <br /> . - Traffic c L.,_.�- � �� '� <br /> � � � Planning , <br /> at-6 e -- <br /> . Remarks j � <br /> Note: Original to Cusromer <br /> , 1CopytoFilc 'i075t�, , <br /> 1 Copy to Inspector Approve ,, / 4� - ' <br /> `/�-��'�� J�'�,^7t,�'.�t,[.C, c �S/�5 <br /> Date Approved <br /> c__ <br />