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AI'PUCATION FOR RIGHT-OF-WAl' US[ PERMIT <br />cvcrctt <br />� <br />ITY ENGINEEHS <br />VERETT, WASHINGTON <br />he Undersigned URV / 17 D� <br />ereby applies for pertnission to � <br />.t the following location � O 7 5. �.Q�/-�DWst v <br />York to be done) <br />�?.� 7'D �'onJ7'�c��� <br />Cw/!�P_ n Zi' �'l�e�X e�„d <br />SEE �ri�3Cl�f�D <br />h A� i <br />)i' i �. <br />OFtIVEWAY SECTION <br />NO SCALE <br />_� <br />j I" L�P <br />30"� �— �30"� <br />OPY OF THIS APPLICATION TO <br />E POSI'ED ON J06SITE. • <br />ALL [NGINEERING DEPT. 259�8811 <br />1 HOURS �EFORE CONSTRUCTION <br />NECK LIST <br />a�ur Valve • � � <br />rainagc . � <br />�r6 & Gulter <br />dewalk <br />Signature <br />tte <br />merks <br />�te: Original to Customer <br />1 Copy to File 110 21 <br />1 Copy to Inspector <br />11021 <br />PERMITN0.7� 3� <br />+ °''r : <br />. { '.t3. .i ' e . <br />t \, { <br />.. .. . y �iGr. <br />i� <br />.S <br />t � <br />m4 •' <br />The undersigned owner hereby agrees to hold and <br />save hartnless the City of Everett from any and all <br />ciaims for damages that may arise l:�ecause of instaila� <br />tion and maintenance of the improvement hereto <br />applied for and turther agrees to rernove same upon <br />n i from thc City and to replace public property <br />da a thereby,. /j ,v <br />Sign�a1 re�o Af ppiicant �� <br />7'd� /O L"'!/�it /�. n. �.Y�, GG+a �/ <br />Address �- <br />3c5��-77CG <br />Tclephone Numbcr <br />9' — � 4 � 7`7 <br />Da[e A <br />��7Ji <br />Dopt. Approvafs <br />Watcr_, <br />Street_ <br />C�,t�mun:^te'-ons <br />Approved by <br />Date Aporoved <br />