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APPLICATION FOR RIGHT•OF•WAY USE PERMIT <br /> everett . 1�246 <br /> e �,- % = � <br /> CITY ENGINEERS PERMIT N0. �-�� � <br /> EVERETT,WASHINGTON � <br /> ,1�1 G: r �� H L C�JIJS T ��-.. _ �� <br /> The Undersigned_ �i � , � �1 � ' ,��t f} !.�. Ll�ri(� ' ` <br /> Hereby a�plies for pertnission to <br /> �.��.7 � r ii �i� l � 1 L —� <br /> At the following location =� �'� �' �" �� " � � �� ��� ' _ <br /> ( �"] � ', `% �� �0 � <br /> _ _ , <br /> SKETCH J <br /> (Work to be done) (�� �y _._ �__,_ �, <br /> (I : " 1 <br /> ; � ti 3.Y ��{J I , <br /> , � <br /> I•4r �� <br /> / / ��.��� <br /> F� <br /> � 35r)f <br /> ` ' <br /> —� u ;� � <br /> _� �� .:� , <br /> oa,t �: � �I..�`' N�,U CONC. �/lAl I <br /> 1� <br /> �' i_ . RENIU I/� � R�PV-�'E CUf7B �; ' <br /> c�� •, <br /> - � S�In/ SEC T/0/V , <br /> � L,�)IUDSCRD/NC� <br /> , REhbVE $ RLPLRCE <br /> I �r,' CUUi;. 7l ',J CUIZB, GUTTER �' <br /> �' `U'v�. :,i: SrD[WALK SECTIDN <br /> � N�'i.11 CON�C, _�!��! � <br /> N� 5L'ALC 'I _ — r L <br /> I l _ -- <br /> � � - <br /> , , <br /> � � -�-- <br /> , _ �- <br /> ' � �.'VF/i� ! I � �� � � <br /> �; <br /> � W a� <br /> u� <br /> ' DRIVEWAY SECTION (�i The undersigned owner hereby agrees to hold and <br /> ��� NO SCn�Ei save harmless lhe City of Everett from any and all <br /> � ��_ � �__� claims tor damages that may arise because of installa� <br /> tion and maintenance of the improvement hereto <br /> +I" LIP � applied for and further a9rees[o remove same upon � <br /> �� 30 _��___ I s� notice irom the City and to replace public property , <br /> � ��- - ---��t' damaged thereby. � <br /> ,�;�l!l. E ( L M. �L -- �' -��C�'� <br /> � ,� ,� � Signature Applicant� / /'�4' �. <br /> 7' GG L �� I L v /i 'S.-s�.�=- 1 NV// <br /> , -- �—� Address. ' <br /> � COPY OF THIS APPLICATION TO ���.,y.�. ��f� c,�;1 7 Z- '� <br /> 6E POSTED ON JOBSITE. Telephone Number <br /> � CALL FNGINEERING DEPT. 259�8811 �7 J'Y" 7 � �' 3 — . <br /> I t��j ,,. ; Date �?'� h �� <br /> � �4 HCIURS (3EFORE CONSTRUCTIOIdI <br /> �- _. _. . -- - j�) - ��'�� <br /> � - - � ---- � Fee � <br /> CHECK LIST � <br /> Wacer valve i Dept. Approvals <br /> Drainage � ���---��� - ' `�- � ' <br /> ue�� c,�� ��` Engineers �// �Ol�� 7- � S <br /> Curb&Gutter � ��o ��--� ��c D � f �Q . <br /> Sidewalk Water <br /> /� A, ���� � �,� Street '�� <br /> � /����;P Communications<'�� - "`p � �- 75_7�� <br /> / - <br /> Inspector's Signature Traffic 7� <br /> " Planning� �"l � � 7)� <br /> ����.� f� <br /> ate <br /> ��`' -^' �(�S!� <br /> Remarks <br /> Notc: Original to Customcr /� <br /> 1 Copy to File ��?ct.6 ' _'� - <br /> 1 Copy to Inspector QPPr9ve5f bY i� �_:�� .:� , ._ ,Q_�=.- �r <br /> �`� t.- � L <br /> � Date Approved <br />