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' � evereft <br />� <br />� CITY EYGINEERS <br />EVERETT.WASHINGTON <br />The Undersigned �� � <br />Hereby applies for permission to <br />At the following location <br />IWork to be done) <br />APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />� <br />0 <br />10538 <br />PERMITNO._._� � <br />15 <br />, , <br />_ ,_ _ _,_ , <br />v-'�". �_ .. � <br />�_— '_' <br />r' i """_ "__'_ `_' . . �__._ <br />. r .l. '�IMY 1 <br />. � _�__- � � .___ <br />NaL- : . .��. .i vier : xf, ...I `\ f ri i��,� /��.� ), ../. <br />�,: • nl. i,.�, � .�.'iuin - � � J... f:. -i <br />1"I i-'. i'� I . � <br />DRIVEWAY SECTION <br />NO SCALE <br />� ( !) � <br />� � �i LIP <br />30'� --� _ __—�30,� <br />COPY OF THIS APPLICATION TO <br />BE POSTED ON JOf351TE. <br />CALL ENGINGERING DEFT. 259�8811 <br />24 HOURS BEFORF CONSTRUCTION� <br />�— -----.___.._--- ---- <br />CHECK LIST <br />Water Valve <br />` Drainaae <br />Curb & Gutter <br />Sidewalk <br />� lT/�C�z.-�- <br />Inspector'sSignature /� <br />�� //%� ✓ — <br />ate <br />// /` .l <br />•"/�. ,�.i� y 9 �� ��L.�.! <br />Remarks <br />Note: Original to Customer � `' � � � <br />7 Copy to File �, <br />1 Copy to Inspector <br />7. <br />N � l; <br />i � ,� . <br />The undersigned owner hereby agrees to hold and <br />save harraleu the Ciry of Everett from any ar.d all <br />claims `,or damages that may arise because of installa- <br />tion an� maintenance o( Ihe improvement here[o <br />applied for and turther agrees to remove same up�n <br />notice frem the Ciry and,to replace public property <br />damaged thereby. � <br />18i�natu/re of Applicant � t � <br />t'":�(, �.1;%K i%—�'i� — . <br />AJdress <br />.. . �� j!_ (. �.. , _ <br />.. ..- .. i%-Y �i'=- / i' <br />Telephone Number <br />�.-_ . �%.:-t.. _-. <br />Datc / / , <br />, _ . .. /'! �_/��_ �. <br />Fee /` <br />Dept. Approvals <br />Engineers_, �. � � "�..-�T_ �,, <br />Watcr .r l. il ��g. .t ' �: .. . ' <br />�cmmunicatic�s, <br />Tra'FPc -�� /�+ <br />Pb.�nnin ��) �,_ %F �%� !� <br />9�. <br />ApProved by � '' .,- / <br />'r:%. <br />Date Approved �� <br />0 <br />