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u <br />, everett <br />� <br />CITY ENGINEERS <br />EVERETT,WASHINGTON <br />The Undersigned �_ <br />Hereby applies for permissic <br />At the following <br />(Work to be done) <br />APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />to � / <br />l <br />10703 <br />PERMIT NO. ' -� <br />�ii. . <br />,', .----�- -- <br />( _ f ---� <br />1 I <br />_' � ""�"_"_."__- ." -�.. <br />s' Ir <br />1 � .. � "_'-�-.._. <br />� <br />� , <br />' v <br />� � I <br />' . <br />DRIVEWAY SECTION � � � <br />NO SCALE <br />T�— —� ��� �,��i <br />� \ +I�� LIP � <br />�30 .- _---_�.30 <br />CQPY OF Ti-IIS APPLICATION TO � <br />BE POSTED ON J06SITE. <br />CAL� ENGINEERING DEPT. 259�8871 <br />� �4 I-10URS 6FFORE CONS��I;UCTION <br />CHECK UST <br />Water Valve <br />Drainage <br />Curb & Gutter <br />Sidewalk <br />� u� ��-�w <br />Inspector's Signature� <br />.--�—.�T� � � �'7 % <br />Remarks <br />Note: Original to Customer /� <br />1 Copy to File 1(� 7l1 %J <br />7 Copy to Inspector <br />C <br />The undersigned owner hereby a9rees to hold and I� <br />save harmless the City of Everett from any and all �� <br />c�aims tor damages tliat may arise because of installa� <br />[ion and maintenance of the improvement here[o , <br />applied for and turther agrees to remove same upon �. <br />notice from the Ciry and to replace p�hlic property <br />damaged thereby. _ .� ���, <br />�--- <br />., , I <br />Signature of Applicant ,�� "; - I <br />". �/ � 'i.-- /`�'� il <br />Address , � � ', <br />- i� - y1 �f,�i., � � „ � <br />Telephone Number � ' � 'i <br />. `.� - /._—._1 )/ i <br />Pee %0 -� .t�� @ �/!� ��7 '. <br />Dept. ApproVals �.--, <br />i v y � <br />[ngineers � ��T�,� �. <br />� 1.:,� �� J� ' <br />Water -�•� � <br />Street � <br />Communications ` � � r .. '� <br />i�. � i , '_ <br />— .i <br />Approved hy � � ' ' . <br />_ ... . ', , � . ; ._. . _,_. .. <br />Datc ARProved - � <br />