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. <br /> APPLICATION FOR RIGHT-OF-WAY USE PERMIT �--�� <br />` evcren �O n ^ q I <br /> L4l <br /> I ' <br />� CITY ENGINEERS �5—/Z � <br /> I EVERETT,WASHINGTON PERMIT N0. � <br /> � The Undersigned -SCn TT Y T//,P/VEIe I <br />� ' E�e,ebY aPP�;�s fa�oe,,,,;ss;o„ co REI'VJLJ I/E /�SPHAL% /-?Nt7 DRI A�EIn/!-)Y To BE REPU�C�`D , <br /> lnIITN SIDE(nIALK) �ll�lD �nNrrsr-.�PE a/I/ R— � — In/ <br /> At the following location /f��� �VE2ET/ A Vc . �. <br /> SK.ETCH � <br /> ' (Work to be done) � I , I � �I <br /> i <br /> ;� � � <br /> '� � i <br /> , EXI ST/NG DRIA�'InlRY I <br /> , O/�KE S AVE . 5 ' �I EX/S77NG S/DEWALK / K!`= � I <br /> _ �� �CONCR.E TE� <br /> EXIST• � }y `„"_ _._' c o <br /> j i ' <br /> i <br /> j � .��� r � - - -- - -- -- - -- <br /> � 1 XISTINC� D/W TO BC � <br /> I V � � REMOVED AND REPL/�CE� I <br /> � � � W/TH CITY STA/YD/-�RD S/W <br /> i � � <br /> . <br /> il i <br /> , � � � ASnraFl L r P�a ViNG TO BE � <br /> ii �, � � I� REM 0 V.E� f I ND REPL ACED <br /> i ! W/TN LANDSL'/aP/NG , <br /> �I `i � ��GU�;�1N� ; <br /> '' �' �' I l8/Z <br />' '� W � � <br /> I <br /> i ( I <br /> � � /� LLCY <br /> �i <br /> i ;' DRWEWAY SECTION /� .SCNLE �The undersigned owner hereby agrees[o hold and I <br />� � NO sCa�E save harmless the Ciry ot Everett from any and all <br />. I —`' claims for damages that may arise because of installa• <br />, i � �� �- � tion and maintenance of the improvement hereto <br /> � - applicd for and further agrees to remove same upon � <br />� i 3�" ___--_---- 34� notice iwm�the City and to replace public property <br /> i <br /> I ��ina�ad,�herebY. �� ', <br /> � `-C% �` I P I <br /> � �� "�n � amreof �pplican � <br /> ( COPY OF THIS�APPLICATION TO � 1 � �7C ddreu ` 'I <br /> I BE POSTED ON JORSITE. �I�Z�j' /J � <br />� � CAL� ENGINEERING LEPT. 259-8811 � Telephone Number � <br /> � 3d fi0UR5 3LI�OR6 CONST�tUCTIONI Date �D ��� I <br /> i <br /> � CHECK LIST Fee ; <br /> Water Va�ve i Dept. Approvals <br />�� �i Draiiiage � � I <br /> i Curb &Gutter Engineer � ��i �A�'l 7 Z� �s� I <br /> Sidewalk Water <br /> I �.s:) : + �, <br /> " � SVicet �� '� - <br /> I ��; i ,,�tz'a..� Communic ti�ns`=7G� -c..00- £S-�=7�' , <br /> 1"ns ector'sSi nature 1- )" �.�...�_ �� <br /> � P 9 Traffic� _-t , 7 ' <br /> I� ' + � / <br />� � _ Planning r <br /> --> . _ ]� .- —.� <br />,� �te <br /> I <br />' Remarks <br /> i <br /> I Note: Original to Customer ' <br />, ICopytoFile �0241 � , <br /> 1 Copy to Inspector AP � '�Y/ ' � q <br /> '� ��/i_. lX(�::rG{/7.�G�<./8 I-�� <br />'i Date Aphroved <br /> � <br />