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everett APP��CATION FOR RIGHT-OF-WAY USE PERMIT i <br /> � 10631 ; <br /> � <br /> CITY ENGINEERS � <br /> EVERETT,WASHINGTON 7/ _ Z3c ' <br /> PERMITNO, �r' d <br /> The Undersianed l�ya��,�7 �r��,t,/j� �J� r� ' <br /> i <br /> Hereby appiies for permission to I ' � � �T�,��- � �� a^ ' <br /> I i���✓ i <br /> � At the follo�ving location �1(-L 3 � <br /> — G�,c- o ,.:�� , <br /> � SKETCH ' <br /> (Work to be done) " � <br /> I, i <br /> j S�= r �� i�.� ���f�� I <br /> I <br /> I <br /> I <br /> � I <br /> � <br /> I I <br /> ;1 <br /> � � <br /> I i <br /> I ' <br /> I f <br /> I <br /> I <br /> I <br /> I I <br /> � I <br /> I <br /> IDRIVEWAY SECTION � <br /> NO SCALE The undersigned owner hereby agrees to hoid and � <br /> i � -_� save harmless the City of Everett from any and all <br /> claims for damages that may arise because of instnlla� � <br /> ' �" ��P tion and maintenance nf the improvement herero i <br /> 30+�-----____ . I 30", applied for and further agrees to rernovc same upon <br /> i� � notice from the City ,nd ro replace public property i <br /> d aged thereby, �� � <br /> ' _ Si ture o 1��ns:tl�r�- �_ I <br /> -- 9 p � <br /> pplicam I <br /> ' COPY JF THIS APpLICATION Tp -�0'�/�{,���/� )�9��5 � <br /> � 8E POS7[D Ot� JOf3SITE. Address i <br /> I ; CALL FNGINEERING DE9T. 259-8g11 Telephon�Numl�er / �S � <br /> 24 HOURS BEFORE CONSTRUCTION �;�S 7�� � <br /> r 1 <br /> I -- ---- —_ _ Date '7 ; � <br /> CHECK LIST -�',`�3 ��1 �G� L��{_ � <br /> i Water Valve Fee"-- �� <br /> , <br /> ; Drainage Dept. Approvals � <br /> Curb$ Gutter ' <br /> . Sidewalk Engineers � ' ,/ � <br /> . Water <br /> Strcet <br /> -- � <br /> i Inspecmr's Signature — Communications i <br /> TraTfic <br /> ' Planning_ � <br /> a[e <br /> __ i <br /> � Remarks -- - <br /> �' Note: Original to Customer � <br /> , �o�Y �o F,�� 10631 � <br /> ! 1 Copy to Inspecror � <br /> Approved by �� <br /> Date Approved � <br /> —�,_ <br />