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everen <br />� <br />CITY ENGINEERS <br />EVERETT,WASHINGTON <br />APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />1OZOO <br />PERMIT NO. �S /p Z <br />� �� �"�1! �;�;`�i <br />The Undersigned •'� �� ��. �. �' �._ ,–; ��� �'� t '.� �� – <br />Hereby appiies for pertnission to L U'��� �� �- � � � !� ��� � � ��� <br />At the following location � ��� � � r1�� � ��. _ <br />(Work to be done) <br />NE I�l ��S' )�F� <br />DRIVEWAY SECTION <br />NO SCALE <br />�.—_-- ! � � � <br />��I" LIP � <br />�3Q�_��� }_�2—__–_�.30 <br />COPY OF THIS APPLICATION TO ,' <br />BE POST[D ON JOBSITE. ' <br />CALL ENGINEERING DEPT. 259�fl:;t i <br />� � Z4 HOURS 6EFORE CONSTRUCTICI_; � <br />�--r--i <br />� ....._......- i i,� I <br />� �� r � �'-�%' 'l �. <br />� ��.,.- <br />�� .�::�,,� - _ <br />Inspector's Signature <br />�(� - i /' - �;' 1 <br />Date <br />Notc: Original to Customer <br />t Copy to File <br />1 Copy [o Inspecror <br />�� <br />In' <br />L"� <br />u�l�i c� y- L �r1 <br />�- ��- �� <br />_� � <br />�J.: � <br />� <br />'M <br />I S,YD�i <br />�a-'" I� _ <br />h <br />�qc� rsF `xisrinic. <br />�ur�n <br />The undersigned owner herehy agrees to hold and <br />save harmless the City of Everett from any and all <br />claims for damages that may arise 6ecause of installa� <br />P tion and maintenance of the improvement hereto <br />4 applied for and further agrees to remove same upon <br />notice from the City and to replace public property <br />damagedthereby. �� /�� ��t–��no1� <br />�9,��. .Ct,� /'�i.»,./� <br />�� Signature of Applic nt " <br />.:-�� �� �-,«,� � <br />Address <br />�SS' �///5l <br />Telephone Number <br />r . i <br />Date ,S–� `� q/Z3�7) <br />Fee <br />-1� � n n� APP�Or b � c,' s�i..L,.t.lv �' ir�� <br />fj�_ �7" <br />Date Appr ved <br />