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APPLICP.TIOIV FOR RIGHT•OF•WAY USE I'ERMIT <br /> �(,.;fe" - 10 6 2 i <br /> _,� ; <br /> �S <br /> CITY ENGINEERS I <br /> EVERETT,WASHINGTON PERMIT N0. �C '.2`�lf ( <br /> The Undersigned_(7AV i iI lS✓L�n�I v J�(� . i <br /> „��1 — <br /> Hereby applies(or permission to �j QS�, v '� .E3- H-�/r� /f ��v,( <br /> At the following location_�� �S G��r'n wvn D� /�✓c: � OT �j S/i o/� t��,y Z' <br /> SKETCH <br /> � . <br /> (Work to be dane) � � <br /> f � <br /> . 3 <br /> J � <br /> .� <br /> � � I�/��.( L.o L.t5 O{ L JCref� <br /> / e <br /> b3 H .� <br /> �'o <br /> = ra�� . �635 1.oT .3 <br /> � �, . <br /> � <br /> yu <br /> �` 5 � . <br /> T f��� .1_,/ riLoP. <br /> b� -y > ' 'i o ay-�- �_ — _ _ .�35G�?�� � ' _ _ <br /> I � / <br /> � f , � <br /> rlw. <br /> j , • . <br /> 1 <br /> DRIVEWAY SECTION The undersigned owner hereby agrees to hold and � <br /> NO SCAI.E save harmless the City of Everett from any and all <br /> r-- —� c'•ims for damages that may arise because of instaila� � <br /> �" L�P � tion and maintenance of the improvement hereto <br /> applied for and further agrees to remove same upon ! <br /> ',30" I . T _I_30"_I notice from the City and to replace public property { <br /> � da aged thgrebyn. � <br /> . ��a,..a.l C( . �hl..,-�.,�r-e��t��. <br /> Signature of pplicant ) ` <br /> .1�'l �'>,-�. lF ZSs"- �71:�.��. li..„ � �s�71 � <br /> COPY OF THIS APPLICATION TO ddres j5 // � y- <br /> dE POSTED ON JOBSITE. S <br /> Telephone Number � <br /> CALL ENGINEERING DEPT. 259�881� <br /> T4 HOURS E3EFORE CONSTRUCTION Date � <br /> � ��' <br /> CHECK LIST Fe� . , <br /> Water Valve ' DCpt. Approvals <br /> �Drainage . � <br /> Curb&Guiter Engineers � <br /> Sidewaik � Water �j <br /> Street l <br /> Communica[ions � <br /> Inspector's Signa[ure Traffic <br /> ' /i <br /> Planning �o <br /> ate <br /> Remarks <br /> � Note: Original to Customcr <br /> , ���Y �� ���� 10 6 2 3 " <br /> 1 Copy to Inspcctor � Approved by <br /> Date Approved <br /> �t%_ <br />