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evere4l <br />_� <br />CITY ENGINEERS <br />EVERETT.WASHINGTON <br />The Undersigned IJl"14 <br />Here6y applies for permission to <br />APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />10327 <br />PERINITNO. ��� <br />At the following location ��'� I� i Ll(i7�L �� 11 t�� �.� �. �� ❑ 1"7 �� — <br />�. SKETCH - i <br />i (Work to be do�e) ..'�/ <br />/11 i-� iJ 1"�- Li i�� i=1V:=,� I <br />� <br />DRIVEWAY SEC710N <br />NO SCALE <br />�- ��� -� <br />j I" LIP � <br />30 _—�� _i—__�.4.30-.� <br />� COPY OF THIS APPLICATIODI TO � L' Wn/. <br />� BE POSTED ON JOBSITE. <br />CALLfSNGINEeRING DEPT.25&8811 <br />, 2A HOURS �CPORG CONSTRUCTION <br />CHECK LIST <br />Water Valve - <br />Drainage <br />Curb & Gutter � _ <br />Sidewalk � � <br />In�\ .r1 /Tj/�,'�� ,,��h. ./ <br />torsSigna' ture � <br />..�^�5 - / � <br />ate <br />Remarks <br />Note: Original to Customer <br />, �ouY to F,�e 10327 <br />1 Copy to Inspector <br />n <br />\V <br />`�� �:�,�,�, rrE <br />, � � �. <br />, � '� 11 <br />�/�„r,.� i \c <br />a � � vu ��� <br />��- �c%-�� <br />i �� �; !'� <br />V <br />N <br />NO 5C1��;_ <br />�' _� � � :._c; i._ : � �. .,., f.. <br />�S�Hn�-r li�w <br />� cr- �xi� ri��� i�n�iu <br />Gp/ <br />IThe undersigned owner hereby agrees to hold and <br />save harmless the City of Everett from any and all <br />�claims for damac�es that may arise because of installa� <br />tion and maintenance of the improvement her^to <br />applied for and further a9rees ro remove same upon <br />notice frc � the City and to replace public property <br />�da ed thereby � <br />Ak�.;� r„���:,�.......�. <br />ig ture o Applicant y <br />�{ .�_ ��/.��f�/.!/�rl. <br />Address <br />�jSJ- // 35 <br />Telephone Nu:nber <br />/ – % `%'- i <br />Date <br />r � � � r <br />'f iJ � � <br />Fee <br />Dept. Approvals <br />Appro e`�li _ 1� .` �Ltn-sG�f� �I–•��–%(— <br />Date Approved <br />