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— A��Ucai i�iv rvn HiciH f-OF-WAY USE PERMIT <br /> everett �0��� <br /> _ � <br /> CITY ENGINEERS � <br /> F�iERETT,WASHINGTON PERMITNO. � !� y7 l <br /> The Undersigned �� �-� '' r'=,i.•:_c- �;'- '.,r,��it—r�..J�-, <br /> Hereby applies for permission to c�,�,•i 5 i RJc i �r-1 �<' C,�„iC,Z•�>.=�/,,.��'y�' �' i '.-1,:11.i v 1= Ao T <br /> - "---'—�-- <br /> At:hefolfowiry^:-�a..'- _ ; lo �s:' Fi.E;���, rIV"v � <br /> ��� ^f-c� � 11._.--� � � i . . . . � <br /> SKETCH <br /> (Work to be done) � <br /> Sc-C l"j���.X l7(=� / }�lit ��, <br /> .� �, ,j , <br /> /.; ^ ,�"� d ,_ <br /> - � �� � <br /> / <br /> DRIVEwAY SECTION The undersigned owner hereby agrees to hold and � <br /> NO SCa�E save harmless the City of Everett from any and aIl ' <br /> r— -----� claims for damages that may arise because of installa� <br /> � �I" LIP � tion and maintenance of the;mprovement hereto <br /> applied for and turther agrees to remove same upon <br /> 30'�,_____ __.4.30" notice trom the Ciry and ro replace public properry <br /> dama� ther by. � ,., � � <br /> t ��' � ,'��NY�—L� � l,n�. � r� /��//n / <br /> �Sic�dature o Applicant.� <br /> � ----- �(i. 2, . //(, � <br /> COPY OF THIS APPLICATION TO Address <br /> BE POSTED ON J06SITE ���f' �""�6/y <br /> . .� � CAIL ENGINEERING DEPT. 259�8f31 I �I Telephone Num6er ' <br /> � ?41-IOIIRS R�FOR[ CONSTfiUC�ilO�d�� Date�, .� � - a <br /> . . . . _ . ._ ._ _- -- i.; � � .0 y/��T� f' � <br /> CHECK LIST Fee " ''Z—��' ' � <br /> Water Valve Dept. Approval5 <br /> Drainaye <br /> Curb&Gutter ' Engineers <br /> Sidewalk /, � <br /> , �;w(';�..,... Watef��_�-y�-f' � .r_F /�i�'�f,l.i. %yJf��,.:� <br /> � StfCO[_(f'C� f <br /> Communications <br /> Insp ctor Signature ��= Traffic � ,__,�_�_ <br /> �;��� <br /> � � � Planning <br /> ' �i " � � , � � i�' <br /> al-6 e � �i 7i C� / /c•.._ �� n;s� .� �. <br /> Remarks <br /> Nole: Ori�inal to Cusromer <br /> tCapyroFilc 10737 <br /> 1 Copy to Inspector Approved 6y <br /> , vare i�pprovea � <br />