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- APPUCATION FOR RIGHT-OF-WAY USE PERMIT <br /> evcretl <br /> - e . soo16 <br /> 1 CITY ENGINEERS -7�/ <br /> � EVERETT,WASHINGTON PERMIT NO. / 7 ��/ <br /> The Undersigned �E�� J AcTI-1���� <br /> � Herebyappliesforpermissionto �Jb�.� � - a2�� NOLES "r{��LY !-1 CU2PS <br /> � O C �� p <br /> � At the followinu location 8 �� �(� �IG�S ON f L- , � <br /> i SKETC:' <br /> �. (Work to be done) <br /> li <br /> , 8817 , <br /> I <br /> � � <br /> ��� <br /> � � <br /> � <br /> � pRAI/� I <br /> L�N£5 ; <br /> � � <br /> I i ' <br /> i <br /> � � ��� ��'i <br /> i <br /> — �- f <br /> � EMERSoN � � <br /> iORIVEWAY SEc7lON �`' �ersigned owner hereby agrees to hold and I, <br /> i NO SCaIE save harmless lhe City of Everett from any and all <br /> ��� I'- --� claims tor damages that may arise because of installa� <br /> I'� LIP tion and maintenance of the improvement hereto <br /> � applied tor and (urther agrees ro remove same upon � <br /> 30';,�_ _ _____y�30" I notice from the Ciry nd to replace public property �� <br /> —i <br /> ' damaged thereby. � <br /> � Si a[�o A plican[ �J �. <br /> _- -7 `I 1 i, f 1+ �� [ <br /> `ICOPY OF THIS APPLICATION TO � A �'3 i Address '. <br /> I BE POSTED ON JOBSITE. ��. �$ ! 7���4 S v i �% ^ �l,i rr � _ �� <br /> Tetephone'iJumber <br /> � CALI_ [NGW�[RINGDEPT. 259$677i (o r � ,� ''. � (t+ <br /> ', � 24 HOI.ih5 [iEFORE CONSTRUCTIOW I Da[e � <br /> —--- ..�_Fe� <br /> CHECK LIST Fee <br /> �I Water Valve cuA�t� <br /> Dept. Approvals <br /> Drainage � � <br /> Curb &Gutter Engineers f !,� ��1 d'(� �. <br /> I Sidewalk � <br /> Water ir ' Prisr�� ,C�/1 . <br /> .� ��� .y� Street �%'. _ _��� - <br /> z � -7✓.c:c.. <br /> , ��r:� lnrni� �G7n,�.CY �' � Communications <br /> �, Inspector's Signaturc � "' <br /> �, Traffic = � --c� / � �, <br /> I Planning � � 7-`7-7� � <br /> ' -7- 11-'lt� <br /> Date ii <br /> IRemarks <br /> ' Note: Originai to Customer � <br /> , �oPY �o �,�� 1_ �Q 1 F „-,. � <br /> 1 Copy to Inspector Approved by /���� � <br /> Date Approved � ' � <br /> 7/��7� <br />