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� <br />� <br /> e�eren APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />; . � . <br />' CITY ENGINEERS <br /> EVERETT, WASHINGTON PERMITNO. �� 3j r <br /> TheUndersigned '.��=,�.� .:� �;-,)i;' <br /> . J <br /> Hereby applies for permission to_'��t ��� o/— / 1�� i° � v^.;' -'71-' ' ' , � ,-r�' - �- - <br /> - �, —'/ `, � —,� <br /> ^ '-'' �', ', . � �� ii Tc� G1.•ir/L�'r t) rxi�—i�i i� �� .� r� � <br /> i <br /> At the tollowing location k'�ia�� I;!'�GT (, t, t•/ <br /> SKETCH <br />� (Work to be done) <br /> :��' � ` , '� ��' , . . <br /> /do� <br /> / ! w� (z ) C�T;:�, �;�;,: , . . <br /> INS�/��LC/� - �I S I"��r. l�i��/�''- ,�' ' �. <br /> SKETeN• <br /> 2 n/�vsf y'et e/ev; t ��„ r. i, -it;/.: <br /> p { eYist �^� Cu/vF��-'� � <br /> 3 . 7Jetev»� ��e tiov� rv��c (, �,�/,/ <br /> 6y hy��'�ahi, <br /> [!, f�/ae e� L'. 6T�S, d5 Cn�'�ii e=?_y-p'�..., .1.5 <br /> in ��_/!r' ���4,/� . . _ <br /> �<. , . <br /> DRIVEWAY SECTION The undcrsigned owner hereby agrees to hold and <br /> NO SCaLE save harmless the Ciry of Everett from any and all <br /> � -- � claims for damages that may arise because of installa� <br /> ��� LIP tion and maintenance of the improvement hcreto <br /> 3O�I I � I I applied for and further agrees to remove same upon <br /> 1"�—�1'—�-------�T30�1 notice trom the Cit and to repl ublic property <br /> dama ed th reby. P <br /> �^ C. <br /> Signature of Appfcant -- <br /> ' � �,�sr c����� <br /> COPY OF THIS APPLICATION TO 1 Address <br /> 8E POSTED ON .10I3SITE. ,3�J�''[ �I Ce I{e�,..[, uZ 'rJ��¢$�,��;k <br /> CALL EiVGINEERING DEPT. 259�8&'11 il Telephone Number <br /> 9 - �5�-7] <br /> I24 HOURS 13EFOR[ CONSTRUC710NI Date <br /> . . . ._ _. ___. _ _.. _ .... <br /> CHECK LIST ND f r" -' <br /> Fee <br /> Water Valve 'Dept. Approvals <br /> Drainage / . <br /> Curb &Gutter Engineers_s �L�',f � ��c�:" <br /> Sidewalk <br /> Water <br /> Svicet <br /> Communications <br /> Inspector's Signature Traffic <br /> Planning <br /> ate <br /> Remark> <br /> Note: Original to Customer <br /> 1 Copy ro File �.' �. , � � <br /> 1 Copy to Inspector Approved Ly <br /> Date Approved <br />