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APPLiCATION FOR RIGHT•OF•WAY USE PERMIT <br /> everetl <br /> � 10959 <br /> CITY ENGINEERS -� � . <br /> EVERETT, WASHINGTON pE!l',tiTNO. /2 b v <br /> The Undersigned�I A�+ r /Y � � �\ <br /> Hereby applies for permission to PV T ��1/ /�'".t /VC�l= /rZ.Lo N(� T l�G �f�i= w/4'.(, �f�)f�/ <br /> —L��R R/ f n ,�� -� �e ,u nin i�c°�or c T/-F �=��o,v r u .� �"���- ��i�.� r.r.� <br /> At the followin location a iv - � vCR�.=�r � vF <br /> �/� /_= Co/p �(/t /t U /— f� ,�2/�iSdN �f'� V��'.�Ti�i_=' <br /> SKETCH S�.f I-'�iPc'rT �y�, �r <br /> � (Work to be done� � • G PQ <br /> -tl ',�0 5� <br /> /.7�. ,� /= � — F� I <br /> e�� _ � <br /> �C N�c 7-v Ru N � v <br /> o P�'- 1 f� �r o �/ N�Re�s�N ; ��z;-�i s � <br /> �ND 30 �=r eN rvrn�.�r, vr. S (�o P� +� �o' �„ � I <br /> � � r <br /> 1✓ ' ~ � <br /> �o � i <br /> � ; ' � , �` <br /> vV /= -- _ _. � . � o <br /> !. \ � �; ,� \� <br /> cvG���r � (� i Q i ' � <br /> � S 1 � ' a'V' i <br /> � � � .� � <br /> � __---% �� � ; ' °� <br /> � � <br /> �Fb' „cy � � � <br /> � ���vE G��✓c� <br /> / _ � , <br /> � _ � . ' 1 <br /> r��oNG f1f�n',z,so�✓ ,�s���o,vG �.__ - 3�� - , , <br /> t/L'� CJ'C,C o�vc rFi�c r � v <br /> ,��� -- � ' S/D%"I�v�i,� ` p�� �r '`� <br /> pri �� , , �y�_ <br /> ►��� y t� T S�;°�K <br /> ` ' r-T vc <br /> DRivEWAV SEC710N � V F � /= � The undersigned owner hereby agrees to hold and <br /> NO SCa�E save harmless the Ciry of Everett from any and al� <br /> f' ----- -��-'� claims for dama9es that may arise becau•e oi installa� <br /> i,� ��P tion and maintenance of the improvement herero <br /> applied for and further agrees to remove same upon <br /> 30" I 30"� notice from the Ciq• and to repface publi pro ert <br /> � —'Y'--�------- P Y <br /> dam i (/l, n <br /> Ol% <br /> Signatur ant,.._ � � - - ,(7 <br /> �COPY OF THIS APPLICATION TO � Address _ n �� ,rv~ <br /> BE POSTED ON JOBSITE. I � j��- ,l f- / / �/7YSH <br /> I CALL EN(;INEEFING DEPT. 259�881 ' � Telephone Nu�����a y �j a-o 1 <br /> 1T <br /> .^�� IiGURS pEFOR[ CONSTRUCTIOh�I Date <br /> __ � h/v FcF <br /> CHECK LIST Fee <br /> Water Vaive Dept. Approvals <br /> Drainage /� y ; <br /> Curb&Gutter Engineers C ���{y�U�'� <br /> Sidewalk Water <br /> Street <br /> � Communica[ions <br /> Inspector's Signature Traific_ <br /> Planning <br /> atu <br /> Rcmarks <br /> Notc: Original to Customer <br /> � iCopyroFlle 10959 � <br /> 1 CopV to Inspector llpproved by <br /> � Date Approved <br />