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APPLICATION FOR RIGHT•OF-WAY USE PERMIT <br /> evcretl <br /> � 1n60� <br /> � <br /> CITY ENGINEERS I <br /> EVERETT,WASHINGTON PERMIT N0. " ' � �/ i <br /> , The Undersigned ����- �' � � �- � <br /> ��, Hereby appiies for permission to � ' � : - ,� :,,,. '�. <br /> . At the following location � ^ � �Y,. %r �.7 .:�� I�� <br /> SKETCH , <br /> (Work to be done) <br /> .vi W -- �',� -- w _�— <br /> I , ! � r. -� i Ii.ti,...� � <br /> � � � 1�rJ.�'.J. � ' '. <br /> i� � f � /}^ ,� I � � <br /> ' l . <br /> I � � � <br /> I,:� ' � � <br /> I I <br /> I • ^ I' 1 <br /> ^ ' <br /> I � � <br /> . � - + r . ' 1 <br /> `' I <br /> . � _�'1 .-.\ � tl� �. <br /> ��, I� '�:� ( - <br /> }O��M� '. <br /> ' i � <br /> � ��� �.pd z�.l�+� <br /> , 'G �JC �..� . <br /> i� __ <br /> � <br /> ; � <br /> . , <br /> ;, �� : ��, <br /> � C_ � .�,��, ' <br /> -� _ ---- <br /> '.. <br /> � <br /> DRIVEWAY SEC7i0N I � The undersigned owner hereby agrees to hold and � <br /> NO SCaLE save harmless the Ciry of Everett from any and al� ��. <br /> '' -� j claims tor damages that may arise because of installa- . <br /> I" LIP� � tion and maintenance of the improvement hereto ��, <br /> applied for and further agrees to remove same upon � <br /> I 30" 30' � notice from the City and to replace public properry <br /> � t`--� �------�� �� � <br /> � � ` damaged thereby. /�� � <br /> 1 �/✓'.j//) ii /<� i YL.�-!�� ! k'0f' <'-� � <br /> Signawre of Applicant � <br /> I ; �(z:� �-��r ��i-- ;r Nl�f- <br /> COPY OF THIS APPLICATION TO • Address <br /> BE POSTED ON JOBSITE. ��. a -,1 � J.-,'ti � %� <br /> � CAIL ENGINEERING DEPT. 259�8811 ' Telephone,Number - �/ <br /> �: — .�O 4, <br /> � � 2�1 IiOURS 6[i"ORE CONSTRUCTION' ' Date ' <br /> � i , <br /> i . ---- _ _ ..- - --- � ir� <br /> � -� '., . ,, ;�.-.. <br /> CHECK LIST Fee <br /> � Wator Valve <br /> Drainage Dept. ApproVals <br /> Curb& Gutter Engineers - <br /> � Sidewalk � , <br /> Water f- � ' � � : �. r � i <br /> //���,�� - '�/.' Street � , . � : . <br /> ' i ie�,!' L/. .�,_5���-C"c ,� ; Communications <br /> Ins ctor' ignat Treffic <br /> �� � Z _.��J Planning <br /> c. / <br /> � ate � - _ l . t . . �_�-�,. <br /> � <br /> Remarks � '� <br /> � <br /> Note: Original ta Cuslomer ��, <br /> , �o��v ta F,�� � n�r�8 <br /> 1 Copy to Inspecror Approved by �\ . , . <br /> .l. <br /> Da�e Approved - �� <br />