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• � �;veren APPLIGATION FOR RIGHT-OF-WAY USE PERMIT � ����.,.;" <br /> •; ' 111 � 0 <br /> , �. <br /> • CITY ENGINEERS <br /> EVERETT,WqSHINGTON PERMITNO. !�-' � � <br /> The Undersigned - i'.%,�_ ;-�. �., <br /> Hereby applies for permission to _- •r..�.� _ , /� �S-� <br /> At the following location �� �, / � �" , - -��"' ,-j„� <br /> SKETCH <br /> (Work to be done) . ��-•, , <br /> \•. <br /> . ` <br /> I <br /> � <br /> 1-- <br /> I <br /> 4'7 <br /> i! 1{ , <br /> : � „ <br /> jiC�Q WFI�� . � --'�-� . <br /> ,� - ------- - <br /> �;,, � <br /> � <br /> � �.�� �,���� r. i, <br /> ' �.; �- r �.� �� ` . ot nri � _.t <br /> � ��� o�����; ` '�� <br /> G���� ch�;�; �� �r,�� <br /> DRrvEWav SEC710N The undersigned owner hereby agrees to hold and <br /> , NO SCALE save harmless the City ot Everett from any and all <br /> � -� claims for damayes that may arise because of installa- <br /> +f' LIP tion and maintenance of the improvement here[o <br /> _� <br /> � ,�p�� ��30„ applied for and further agrees to remove same upon <br /> �'— notice from the Ciry and to replace public property <br /> damaged thereby. <br /> .� <br /> . f�. �� i '� ' -� 'V �1 � ''�, � � <br /> Sign3ture of Applicant r i,1 <br /> ;y�� , 1��\� ` <br /> COPY OF THIS APPLICATION TO Address " <br /> BE POSTED ON JOBSITE. -,���'1 - lp�'1 � j"�� � <br /> CALL ENGINEERING DEPT. 259-8817 Telephone Number <br /> �� - �' - 1 G� <br /> 24 HOURS BEFORE CONSTRUCTION Date �n_ ` <br /> CHECK LIST � ��� <br /> Water Vaive Fee <br /> Drainage Dept. ApproV815 -�. <br /> Curb& Gutter ' � - i � <br /> Sidewalk Enginee[s� � �� � ' i=-�--� � . : �; - � <br /> � Water <br /> ` Street_�` <br /> s t s Signature <br /> Communications \ <br /> ///��� � Traffic ��\ <br /> � . Z., � 7 Planning } <br /> ate <br /> � <br /> Remarks � <br /> 11120 — , <br /> Approved by . . . . ._.i ,� � . . <br /> I '� I [��.<.; i <br /> INSP[CTOii'S COPY Date qpproved 0 <br /> C� /' . , <br />