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APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br /> • everetl _ �O c O o <br /> . � O O <br /> \ <br /> ��. CITY ENGINEERS � ��� <br /> EVERETT, WASHINGTON PERMIT N0. ��� � 2 2 �l ; <br /> � TheUndersigned �/4n/rf �}li �.,C - J�.�1,� L No�i� �faf r� I, <br /> �� Hereb• a lies for ermission to p � � "' /:,t k n v/ �� <br /> 4 PP P �%�r��o�nr.,x� �., �to/ .a o' x :�3: n� �. ,, <br /> At the following location i�n 1 Ev- �e tt �a ✓(�.. ��� <br /> ' SKETCH <br /> ' (Work to be done) <br /> � � <br /> �+ � <br /> �Y�' EVQrGC"t �✓C. �, <br /> . � �/ V�/ _ t1/ I <br /> � � ��.c� �.�,�.�� �� <br /> i � � �• _ <br /> �� I �,,d I �� <br /> n' <br /> I ioof , <br /> Iq <br /> � I �o� � <br /> � o�. � <br /> � i �� <br /> y�, 'p .7 =vE•.:Zt� <br /> lS� D N v . i <br /> I 7 c �ae�-,� <br /> , ; io�oil� <br /> � � � � � Lrn;.nn� � <br /> p �7 � <br /> i � i <br /> ,� .�� I, <br /> . VI0�,4 . �I <br /> � � <br /> � N A���J I <br /> - I <br /> � I <br /> � <br /> i <br /> I <br /> I�, OervEwAv SECTiON I The undcrsigned owner hereby agrees to hold and I <br /> � NO SCaLE save harmless the City of Everett from any and ali � <br /> �, �"— ---""-�"-"'I claims for damages that may arise because of installa� i <br /> ' p� ��p tion and maintenance of the improvement hereto � <br /> � applied tor and furthe�agrces to remove same upon I <br /> � 30'� ___�30'� notice from the Ciry and to replace public properry � <br /> damaged thereby. �� i <br /> � /l�'G/�) A/ /YC, _�' �� <br /> Signature of Applicant � <br /> ,� 1_- �i-rr iy .E-. <br /> . COPY OF THIS APPLICATION TO ' Address �-+ ' <br /> BE POSTED ON JOBSITE. �S_� � �� � 7 G �� <br /> CALL ENGINEERING DEPT. 259-8811 Te ephone Number �, <br /> �— 3 0 - 7� <br /> � ' ?4 HOUit; 6CPORE CONSTRUCTION Date -�-� � � <br /> _ -------- .tIO,U� <br /> � <br /> CHECK LIST Fee I <br /> Water Valve Dept. Approvals � <br /> Drainage ; / I <br /> Curb&Gu[ter Engineers �' r �<.�`'' <br /> Sidewalk ; <br /> Water� \1��. ��. Nl����r�,_ r���'-�V <br /> '��, Street %. .�';� � � <br /> , _ <br /> I Ccmmunications �t��-; f',..,��y .��:,, �:� .- <br /> I Inspec[or's Signature � <br /> Traific <br /> . Plannina � �'� � <br /> ale �y�..tn �� � �l v p✓f �t-vcr„e. Idzt�tiy II <br /> � <br /> i <br /> Remarks I <br /> ' Note: Original to Customer I <br /> 1 Copy to File � (��(�� '� <br /> 1 Copy to Inspector �� � v � Approved by,� . i :?; � <br /> ,_ � i , ; 7i <br /> 6.�% �i i. <br /> Dale Approved <br />