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APPLICATION FOR RIGHT-OF-WAY USE PERMIT 1112 6 l`� ��` <br /> . , everetl <br /> � 1 <br /> 1 <br /> CITY ENGINEERS .` ,_ <br /> EVERETT,WASHINGTON PERMIT N0. '� �'' <br /> The Undersigned � � <br /> Hereby applies for pertnission to � - <br /> At the following location Ef::"� /�' `', � r r`S c`- ,.�'?< t� �' c' <br /> SKETCH <br /> (Work to be done) � <br /> i \ � , <br /> I / <br /> ��� � � <br /> / � � <br /> I <br /> /�// :../' _"_ "____'"�'.� "___. .._. _ _'__.. ._._ .__. . <br /> 1 1 I <br /> 1 . <br /> � H�ca <br /> ' // i�'`�� ' <br /> `;i :`' %, i�1 - 2., __� <br /> ������."__ � n — --------- ----� <br /> .. _ '�T-�-�F„rc� _� _ �., <br /> _ �^ iIJST�L�-- �z�- <br /> G��.�t E �-f" <br /> \ I <br /> '�`, ^�r-t � voU nr �. � � �:: t � � r_� :: <br /> _ --- ` ;, I +��-r�A � � I Z� � � I�l '� <br /> _v � r-r' �� ti�rEt= L ��' <br /> _ �. i�� , � ,,� <br /> __ , � <br /> DRIVEWAY SECTION The undersigned owner hereby agrees to hold and <br /> nl0 sCaLE n save harmless the City of Everett from any and all <br /> r---- — - ---{ I � � claims for damages that may arise because of installa• <br /> L� LIP J.Q`�� tion and maintenance of [he improvement hereto <br /> (�� applied for and further agrees to remove same upon <br /> i 30"I_ _ _ �30", notire from the City and to replace public property <br /> /�„ damaged thereby: , <br /> � n� <br /> �I' Signature of Applicant <br /> I�L - � :, _ <br /> COPY OF THIS APPLICATION TO I / ` T Addrexs <br /> BE POSTED ON JOBSITE. I �/ yv ' � '�"' <br /> CALL ENGINEEtiiNG DEPT. 259�8811 � ��� L� '\ Telephone Number <br /> 24 HOURS BEFORE CONSTRUCTION �� �� ����/ Date <br /> CHECKLIST �pJ �ly`�' �{!,.ro�4.� Fep <br /> Water Valvc l r� �4� � � Dept. Approvals <br /> Drainaye �/ '�� . � � _._� <br /> Curb & Gutter �� Engincers_� � � " " � . <br /> Sidewa�k � Water \ <br /> � � Street � <br /> Communications � <br /> Inspector' ignat re Traific `\ <br /> 3 3/ r/0 Planning <br /> 0 <br /> ate �� <br /> ,\ <br /> flemarks — <br /> 11126 � - <br /> Approved by�, � � . .� __.; <br /> 'i <br /> �� Date Approved . , �� <br /> . � INSF.-:TOR'S C7PY . ' <br />