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everen � APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br /> ` ., e iizs2 <br /> CITY ENGINEERS / <br /> _ + EVERETT, WqSHINGTON � PERMIT N0. / ��' I �= ` <br /> � � � % <br /> ' i <br /> lhe Undersigned '�� i :�I i C� � �:� 1 �. '( '- n� ��,/':- �rf c'J <br /> Hereby applies for permission to ' � � ���-{_ . ' --� <br /> �� At the following location /!'(>�] '� -_ <br /> ' <br /> SKETCH _ <br /> (Work to be done) • <br /> 1 ���,_ <br /> �\ � <br /> �'� �`��- <br /> \`)_ . \ -- <br /> �� ti�� /, <br /> '`�v��Gl� 1�(Sr?; �� � <br /> Fti�� � � , q� ��,� � . � / ,��, <br /> __\ <br /> � o` / <br /> c ,� Ota � ��n� �`�u <br /> ' � e <br /> ��' ��� <br /> , <br /> ,\ <br /> � <br /> ,� <br /> DRIVEWAY SECTION ��'���he undersigned owner hereby agrees to hoid and <br /> , NO SCALE__ save harmless the City of Everett from any and all <br /> r------ � claims for damages that may arise because of installa� <br /> �- 1 i" uP tion and maintenance of the improvement hereto <br /> 30" _______ _ 3p�� applied for and further agrees to remove same upon <br /> notice from the Ciry �nd to replace pu6lic property <br /> damaged�thereb'y. ,�^ ' � <br /> ._�C�'� / 1 f �C�L <br /> S�gn�ture of Appl�cant �-- _ <br /> i". �1. �'�-� G``�( `r-' '1(�l� ) , .r- .: - . <br /> COPY OF THIS APPLICATION TO Address -� <br /> BE POSTED UN JOBSITE. J���- Cp /� <br /> CALL ENGINEERING DEPT. 259�8671 Telephone Number ` — <br /> %^ l ?i: �i .'� <br /> 24 HOURS BEFORE CGNSTRUCTION Date -- <br /> CHECK LIST Fee <br /> Water Valve <br /> Drainage Dept. ApprOVals <br /> Curb&Gutter Engineers � � -- � <br /> Side k <br /> - Water <br /> � � ' � �i� Street <br /> Ihs`p.xtor s Signature Communications � <br /> Trafiic ` <br /> � <br /> _ � — � / Planniog � <br /> 6ate <br /> � � -- <br /> Remarks <br /> 1i2az <br /> Approved by .. .�: ' ', ,.. , �- , <br /> � r^ i '� 'r-, �'�1 - �'�I ' I <br /> INSPCCTOR'S COPY" Date Approved -/-. �' -�,� . � ' 9 <br />