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APPLICATION FOR RIGHT•OF-WAY USE PERMIT <br /> everen �O O 0 4 <br /> � � <br /> CITY ENGINEERS G /Q <br /> � EVERETT,WASHINGTON PERlv11T NO. � � /! / <br /> ' The Undersigned L C �_ N . V,�N �/�1 N K 1_� � <br /> � Herebyappliesforpermissionto CONST�� . A . � �J � Wll7� !� S/�/,� rJS�vNCWAY � <br /> �� At the following location 5�G3 �>�--E N W Of�4� �`� � - --- I <br /> � SKETCH <br /> '� (Work to be done) ` i <br /> i <br /> i <br /> � <br /> �I N� S�A�.E � <br /> � � T � �� <br /> I '' <br /> � /2 � - �p � <br /> .�, 5 3�3 sia' <br /> ; <br /> i , <br /> � <br /> I � E`�tST GRAVt�_ 5 W '— - <br /> � EX1ST C.URB — 22�_ --- --- -_ � <br /> � �5 Gl—CN \NUOD I <br /> P��/E <br /> � <br /> IDRIVEWAY SECTION The undersigned ow�er hereby agrees to hold and <br /> . NO SCaLE save harmless the City of Everett from any and all <br /> ' � - � 5' --� claims for damac�es that may arise oeceuse of insta!la� <br /> � tion and maintenance of the improvement hereto <br /> +�" L�P [����} applied for and further agrees to remove same upon <br /> � �30 I � 30�.� notice from the City and to replace public property � <br /> 'Y�-------� <br /> dama;e 3fiereby <br /> i � � r <br /> .._ . '1 ra.,,.�—� <br /> � Signature of App�i' nt / , <br /> � 7'7 / � /-'/-�..F�• -.�-��� '� <br /> ' COPY OF THIS APPLICATION TO � Address <br /> ' t1E POST[D ON JOBSITE. 3S 3- 3S 2 <br /> Telephone Number <br /> CALL ENGINEERING DEPT. 259-8811 � - � _ J t� <br /> ?4 HOURS HFFORE CONSTRUCTION Date , <br /> � - �, J � B+e1� �l "7- 5-�l/ <br /> CHECK UST Fee <br /> Watar Valve *i� ;if .. �EC�P �'�� �C. Dept. Approvals � <br /> Draina9e -/'KF•v6A.�•.i�n, � (�-'z4--74 �. <br /> Curb&Gutter ����rcP Engineers �l�`�� � �� {Z <br /> . <br /> � Sidewalk ���u'� Water <br /> Street <br /> ��,�'��� Ccmmunicati� - <br /> Inspector'sSignature Traffic � ^ %ty <br /> Planning �r � � 1�T,�% <br /> a[e <br /> I i,l) IJ . .�� e��..::�1 —(li. � .iJ� �:'%p!C/1 CF�(' : _ ' - �. <br /> � Remarks � �I ;ir.,S�l.� )-1���1� <br /> Note: Original to Customer , <br /> 1 Conv to Filc 1.O�O [� <br /> 1 Copy to Inspector Approved by <br /> r <br /> Date A pr ved � <br /> ����� <br /> -_�- - .. __ ._ <br />