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APPLICATION FOR RIGHT-OF•WAY USE PERMIT <br />cveretl <br />.� <br />CITY ENGINEERS <br />EVERETT, WASHINGTON <br />The Undersigned � -�i- <br />Hereby applies for permission to <br />; -. <br />At the follnwing location /-�- - � ��-� � �-� � � ! � L'�_ <br />(Work to he done) <br />;. ����, <br />� �c,,� <br />S ,J�'L�``� <br />� � ��' <br />��(�r .K <br />_ l'..r� , <br />ORIVEWAY SECTION <br />NO SCALE <br />r -- -� <br />I" LIP <br />�3��__.---___ 30„ <br />1_. _ . . . _ . _ _.. .i <br />CONl' OF �THIS APPLICATIUN TG <br />I BE pOSTED ON JORSITE. li <br />ICALL ENG!NEGRING DEP'f. ?59�f381 7�� <br />� Zd HOUit� GE1=0RE CONSTRUCl ION I <br />CHECK LIST <br />Water Valve <br />Drainage <br />Curb & Gutter <br />Sidewalk � . <br />Inspector's Signature <br />hemarKs <br />Note: Origina' to Customer <br />1 Copy to File � O C� n 7 <br />1 Copy to Inspector <br />�' <br />� : , ; i ' - : -i � r r . �i� <br />�.U907 <br />PERMIT NO. � � J' "' `" <br />Tlie undersignec: owner herchy ogrees [o hold and <br />sa:e harmle�s the City o! Everett tirom any and all <br />claims for damages that may arise hecause of installa� <br />tion and maintenance of [he improvement here[o <br />applied for and further agrees to remove sarre upon <br />notice from the CitY and [o replace pabliqproperry � <br />damaged thereby. �%i-- -�_ . �- . �/ <br />�) �' <br />�+`�., � . .� �. ,.. . — ( !' •'� : - <br />,ngnature of Applicant � - - � - <br />L�i: p �' ��i'/:/ <br />Address <br />— /- ,,[ _. .�"� , , o <br />Telep one Number , <br />Date <br />B <br />Dept. Approvals <br />Engineers ����%� <br />Traffic <br />Planning <br />,approved by <br />Datc Ap�roved <br />