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.� <br />evrren <br />,� - <br />CITY ENGINEERS <br />E V E R E Ti, NlASH I N GTON <br />APPLICATION FOR RIGHT-OF-NlAY USE PERMIT <br />10794 <br />� <br />PERMITNO. �'��/�_ <br />The Undersigned ��f'� ( �� /� n �' ��l/fl/t/; 7j? <br />r . -/ � A ' .i <br />Hereby applien for permission io,_„ � � �� �� �/'� : � l 1 /� "� C / ^ �'�:: r' � �%��.�J <br />i <br />Al [he followina location �lo /! G o�/J '� L �D <br />(Work to be done) <br />� <br />5� Q -p,-r� �c Ff ED <br />�.i <br />DRIVEWAY SECTION � /� 77 <br />NO SCALE � <br />� --� � � %',L <br />1" LIP i I <br />i �..ti_ __ � '_.—_'__'.�: O I <br />f' 3 •1 <br />COPY OF THIS APPLICATIOV TO <br />BE POSTED ON J0251T[. <br />CALL ENGINEERING DEPT.:�78611 <br />24 IiOUfiS BEFOflE CONSTRUCTIOfJ <br />CHECK LIST <br />Nlater Vaive <br />Draina.�e <br />Curb & Gutter <br />Sidewalk <br />Inspecior's Signature <br />LSate <br />Hemarks <br />hJote: Urigin�l to Customer <br />1 Cnpy to Fi�e <br />�. 1 Cupy to Insuector <br />10794 <br />The undersigned owner hereby agrees to hold and <br />save hartnless the C�ty of Everett from any and aIl <br />claims (or damages that may arise because of installr <br />tion and maintenance of the improvement hereto <br />applied (or ar.d further agrees to remove same upon <br />J� ce from the Ciry and_tq replace public property <br />�lama�ed thereby/i; / � '. �% <br />•, / � : i <br />� .l • •_� �i :' /i:_.r✓"'�.G�_ <br />Sign`ture o/f Applicant � <br />✓•'� / �• [�L' � 2 �: .1L� Y.. t�:.a.y <br />Address <br />: j.,T' ! ` 7 � 5.'.' <br />Telephone Numher � � <br />.ir,2L.l�� . <br />Date • <br />Fee <br />aept. Approvals <br />Eogineers _ <br />Water ^ //%�. _ <br />Communicotions � <br />Tra(fic _ <br />Planning <br />ApproveJ by <br />