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e'veretl APPLICATION FOR RIGHT-OF-WAY USE PERMI'f <br /> e sso32 <br /> CITY ENGINEERS ,,� ' <br /> EVENETT,WASHINGTON PERMIT N0. <br /> The Undersigned _I�/rl f�i•i�-� !Zl_ rkr:r!. �/ _ , <br /> Hereby applies for permission to %'nivc—i i � , �� (� � f:)�p,</.4 L i (��i�� '', <br /> At the following location �fl,/I ��.i=��n�.i�oTi __ _ � <br /> i <br /> SKETCH <br /> . �Work to be done) �� <br /> S,',_= �-1 i T�=1 CN F. i> <br /> � <br /> � <br /> � <br /> � <br /> I <br /> � <br /> I <br /> � <br /> I <br /> I <br /> , , i <br /> I <br /> � <br /> ,. <br /> I <br /> I <br /> ' I <br /> ORIVEwaY SECTtON The undersigned owner hereby agrees [o hold and I <br /> NO SCAIE - save harmless the City of Everett from any and all <br /> . f'— --� claims for mages that may arise because of installa- �I <br /> +I" LIP � tion and m intenance of the improvement he eto '� <br /> applied for nd further aprees to re ovc same upon , <br /> I 3n" I ___ ___ I 30" I notic f the City and to r pul Ifc pr perty <br /> �' =..t�. .1.. .� <br /> dama <br /> �-' I <br /> Sign re of A pli nt <br /> - -- --� ��- ' r- <br /> COPY OF Tiil3 APPLICATION TO Address �� � <br /> BE POSTED OM J08SITE I �S� � �� � _ � <br /> CALL ENG�PJEERI�:G DEPI. 259�8Ett 1 '� Telephone Numher , <br /> ���� <br /> IOUftS L',�FC�RE CONSTRUCTIONj Date p�� 5v �� �f �� <br /> � � � -- — .C�' , <br /> CFIECK LIST . Fee � � , <br /> Water Vake DBpt. Ap fOVels <br /> �i Dreimge . L� -"�/' �J�� . i, <br /> Curb&Gutter Engineers � /k6�� � <br /> Sidewalk Water I � <br /> Street <br /> Communications_ <br /> ' Inspector's Signature Traffic <br /> Planning <br /> —bate -- <br /> Remarks <br /> Note: Origiaal to Customer <br /> ` 1 Copy to File 1103 2 <br /> t Copy to Inspector Approved by <br /> Datc Approved <br />