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• everett <br />� <br />C:TY ENGINEERS <br />EVERETT, WqSFIINGTON <br />APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />1fJi9�0 <br />PERMIT N0. � � 2 -. — <br />The Undersigned lfi ! L i'�. %/,�,avi" K <br />Hereby applies for permission to i.� �ii c r,� /G ,` � � S� �:j - i/-j q[ i i„1_ _ <br />� I. <br />At the following Iceation -�-(��-S"--"`�' f� � "'1 �' �� �� i-. . . . <br />(Work to be done) <br />� � . <br />�i: !c ii ! r`�i L/ /S '•� <br />�RIVEWAY SECTION <br />NO SCALE <br />� —� <br />��I'� LIF <br />i <br />30" _ _ I 30" <br />---T <br />COPY OF THIS APP, JC.qT�ON TO � <br />. BE POSTED ON JO¢SI-i E. <br />! CALL ENGIfdEERING DEPT. 259�887 7 <br />� 24 HOURS EtEFORF CpMSTRUCTION� <br />� --------- - ---------� �--� <br />I CHECK LIST <br />�I Water Valve <br />Drainage <br />Cur6 & Gutter <br />I Sidewalk <br />Inspector's Signature <br />; ate � ! <br />I ;J,��i�� <br />� <br />, Remarks <br />Note: Original to Customer <br />1 Copy to File �_ O� 3 O <br />1 Copy to Inspector <br />The undersigned owner here6y agrees to hold and <br />save harmless the City of Everett from any and ^II <br />ciaims for damages that may arise because of installa� <br />tion and maintenance of the improvement hereto <br />applied for and further ae�ees to remove same upon <br />i�otice from the Ciry and :o replace public propertv <br />�'/�/y> _ ,� <br />fee �i r�`' <br />� , Dept. Approvals <br />� rf <br />Engineers G� � �.G-�.--,' <br />Communications <br />Plann <br />� <br />Approved by <br />Date Approved �. <br />