|
everen
<br /> APPLICATION FOR RIGHT•OF-WAY USE PERMIT
<br /> e so62g
<br /> ' CITY ENGIp'EERS �
<br /> EVERETT, WASHINGTON PERMITNO. `
<br /> The Undersigned :� r � �
<br /> � Hereby applies for permission to ` �� ��� i �� ..
<br /> I� At the following location � - '� -• �. 3 -i - ' �I�,
<br /> SKETCH i
<br /> . (Work to be done) ��
<br /> - -----�-------------- --- -----— ---------._._.-- --..�'_----
<br /> � Lt,� I�
<br /> , ,•{,��,�' �: �.��� .
<br /> -�---- _. �'(.nt .
<br /> I
<br /> �..�
<br /> r � , . . �.• /.�.i Yr., i i
<br /> •r ' j � I
<br /> ... t ('/J C �.
<br /> I � '�
<br /> , �
<br /> ` -- ------- --— --- �:, ,:�.�r: , ;
<br /> ��� � � 1 � ,. „ , , � 1., � ir �,�,. �
<br /> ,\ � , . \ � . � i, cr� t
<br /> i ��\��` ::,,,, �� � . „ . ,
<br /> �, �� . �
<br /> �_�f .,' — _ , ��+c .__.:...:.�— . .��
<br /> -- t, --- � ' ,�. _.. i.; — �.l -- -'-=----
<br /> � I
<br /> � � �� „ . .��:z
<br /> - , — - _ _ _ __
<br /> - --____ . _ . ___-----
<br /> - - _` , !� r,� `
<br /> ir,.-,� ,. ,._u
<br /> �.� :
<br /> ' DRIVEWAv SECTION The undersigned ovmer hereby agrees to hold and ,
<br /> ! NO SCa�E save harmless the Ciry of Everett from any and all '�
<br /> � �--- --� claims for damages that may arise because of installa� �
<br /> , �" L�P tion and maintenance of the improvement hereto '
<br /> j applied for a�d turther agrees to remove same upon
<br /> I I 30" � I 30' I notice from the City and to replace publi� property �'
<br /> t��--�----�T--"I
<br /> i �damaged thereby. __ , �
<br /> I
<br /> . Signature of Applicant � f�
<br /> --- i — . .- - �"� i��j i
<br /> COPY OF THIS APPLICATION TO Address � �
<br /> BE POSTED ON JOBSITE. " � � �` I
<br /> i CAIL ENGINEERING DEPT. 759�8811 Teiephone Number ;
<br /> � Date � t_ �
<br /> 24 HOURS f3EFORE CONSTFUCTION I _
<br /> ___ _ _- __— - - � ;;f �il , I_„_. �-��/7.�s�
<br /> I CHECK LIST Fee i .
<br /> Water Valve Dept. Approval5
<br /> �
<br /> � Drainage . , � . � �
<br /> Curb &Gutter Engineers � � TG
<br /> Sidewalk Watert' � ',... ��c-n Nlr.:. .� , . . i��t,d�r��tC .
<br /> . s � w r� - �-�•--- � � Street � !
<br /> Communications
<br /> Inspector'sSignature Tratfic � �
<br /> : , �
<br /> �' � �y 7 Planning �- %!%i,;:. .��"7�:
<br /> ate � r ,�7 _ 1.) C -i� � . ;,(- ��. 1:t�
<br /> Remarks
<br /> ' Note: Original m Customer � �
<br /> t Copy io File 1 n�7 9 .
<br /> 1 Copy to Inspector Approv�d by �
<br /> � �
<br /> Da[e Approved .
<br />
|