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eyerett <br />� <br />CITY ENGINEERS <br />EVERETT. WASHINGTON <br />APPLICATION FOR RIGHT-OF-WAY IISE PERMIT <br />10001 <br />PERMITNO. �`-F�-I,J <br />TheUndersigned ROY N/aLVE2SON <br />Hereby applies for permissio� to C �N STP U C7- /� ' COiYG��2E TE O.Fi'l I/EG✓AY <br />At the followinq location 'Z C�� MLID/S�N �i=' � T"Fr %=r"7—"' <br />(Work to be done) <br />Z� 3 <br />GRAI/EL D�W <br />D�W <br />IC.�w 21 �,ir.,-.%' -; dn„ <br />��W bil <br />n ��- <br />IYll�D1SON ST. <br />DRIVEWA`� SECTION <br />NO SCALE <br />�-- �6 � � <br />+i" LIP � <br />� 30��/'—_ I 30�� <br />r— --'r <br />COPY OF THIS APPLICATION TO <br />BE POSTED ON JOBSITE. <br />CALL ENGINEERING DEPT. 259-8871 <br />24 HOVRS BEFORE CONSTRUCTION <br />CHECK LIST <br />Water Valve <br />Drainage <br />Curb & Gutter <br />Sidewalk <br />�� G'1i>d-tJ� <br />Inspector's Signature <br />/� -�/ �� <br />ate <br />RemarY.s <br />Note: Oriyinal to Customer <br />1 CopY to File <br />1 Copy [o Inspec[or <br />� <br />� <br />� <br />3 <br />� <br />J <br />� <br />s <br />G C URB <br />�R-O-W WIDTH V/ai21E5 <br />DUE Td T/� PER_ <br />The undersigned owner hereby agrees to hold and <br />save harmless the City of Everett from any and all <br />claims for damages that may arise because uf installa- <br />� tion and maintenance of the improvement hereto <br />`� �? ��1 applied for and (urther agrees to remcve same upon <br />notice from the City and to replace public property <br />damagediflereby. �� � <br />/� r''. � <br />SigRat � Ap licant � ' <br />- 1 �- ��,� �=� � �, ,.y <br />Address , ' � , <br />i� <br />i e�cpnone ivu�noer S �,5—_� � /� <br />i� <br />Date <br />8 �a �� P� iz -�-�y <br />Fee <br />Dept. Approal�gf Z 3 <br />� O � " � Approved by <br />�iiiy <br />Date Approved <br />.1�.�C. 9, �� <br />%Y- <br />