6113 GLENWOOD AVE 2016-01-01 MF Import

A°PLICATION FOR RIGHT-OF-WAY USE PERMIT 4' , ev;rett 10 7 6 6 � I� CITY ENGW[ERS � cVERETI',WASHINGTON PERMITNO. 7�� ' i The Undersigned.� ��r� I� is ri i1�%t�Y� I Hereby applies for permission to �,Y ' ��S 7 :' ��' fl� aL� %a�/�/' ') e-i l7��i-� '� At the tollowing location (�_//� ��=� y_1!� >s%tL - '�— ��' i i SKETCH � � (Work to be done) � � f�1�` d�(�' . � i �jrY r 1 'rfLF i � i , i I I i I i DRIVEWAY SECTION The undersigncd ow.ier hereby agrees to hold and NO SCALE save harmless the City of Evarett from any and all �� ' l� —� claims fo�damages that may ise because ��f instaila� I I�� LIP tion and n��intenancx ot t� � improvement hereto � applied for ther a es[o•?move same upon , �;,�__�— _,.�.30�� notic om tJ� rty a to replace puolic property •� �. d aged tlx�reby. i . i u e of � lica t � z O G r � COPY OF `HIS APPLICF•,TION TO Address ' � BE POSTED ON JOBS�TE. � - Z"1 � Telephone Number � CALL ENGINEERING DEPT. 259�8811 24 HOURS BFFnRE CONSTR:ICTION Date � �,, , ----�----- --- —� --- � � �G� ��L,�. CHECK LIST �� Water Valve Dept. Approvals Drainage � � ' �� r � Curb&Gutter Engineers� — Sidewalk Water ��^ �� ' . 1 ----�� f�_�,�%ry i i � Siree[� � -5/�-%�97 � � , Communications � Inspector's Signature Traffic Planning �, � f � atc - Se�, �i t .t_.,�.,!��.-.�..�, � � Remarks Note: Original m Customer ��r � � t Copy to Filc � 1 Copy ta inspec[or �� Approved by � Date Approved —�;