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AP!'LICATION FOR RIGH'i-OF-WAY USE PERMIT <br /> ercrett �r'��� <br /> � u <br /> CITY ENGINEEFtS _ � <br /> � EVERETT, WASHINGTON PERMIT NO. � � � �i�"' � <br /> i I <br /> The Undersigned_ � �1 � � � �,/ '� : ,_.� �.i <br /> Herebyappliesforpermissionto � ��;UJ" � �t�L�LI - ��_ � � f���;lLl��" �;�_ �j,,// � ' <br /> ��-7 1B — <br /> At the following location ��� � �L/ I-���1.�1�'�� `• 1,i �-��L , <br /> L?Lll-iLc :� L �1T� i/; ; I-!l_ <br /> �KETCH <br /> IWork to be done) �L � <br /> I <br /> I 2 C D N C h?� �';_ v/ilJ'� <br /> � <br /> � <br /> � � <br /> � _n_ � � <br /> , � <br /> , <br /> N ' � <br /> N i ' a <br /> � IG <br /> I t <br /> ' ' � <br /> � ' � <br /> �� '�/%���- �� <br /> j � <br /> � <br /> i � <br /> I <br /> I <br /> �,� CUG�� L�� i"Xl5 / lld� <br /> —�— $ Ji O(� � <br /> � � <br /> � � � � <br /> ���. _v_._.. ,_ � <br /> � r, i <br /> } DRIVEIYAY SECTION � � <br /> (" i � The undersigned owner hereby agrees to hold and <br /> � I�� NO SCALE save harmless the City of Everett from any and all <br /> �, �--�� /.i � I claims for damages that may arise because of installa� �, <br /> � i��� LIP J f? tion and maintenance of the improvement here[o ' <br /> � �30 /o __�3p�� � ��- applied'or and Turther agrees to remove same upon �, <br /> 'f' - �1 notice from the City and to replace public property ''�. <br /> dama ed reb �i <br /> � S' na9ur�Appllcant�° ' . <br /> _ _ _ /�Q �V 27G7 � <br /> � COP`i OF Thlla >rPLlr. -i I�)�l i O �' � `'!.�.�..( �_; !,' � 17;� ?,�- Address . <br /> [;E- POSTED ON JOf�51�I-L � � i_ 1� , J -1 � �>�3^�f(J Q I <br /> CALL EfJGINEERING DEPT. 259$b71 I Telephone Number I <br /> 24 HOURS BEFORE i�OIdSTRUCTlO`I' Date �I <br /> --- - . . _ .. ._ . � / � / <br /> __ / -; ;,. � da�s. c9. // LLj1 ' <br /> � CHECK LIST Fee � <br /> � Watar Valve , lT <br /> �:�� � Dept. Approvals <br /> Drainage `- �- � <br /> Curb&Gut[er Engineer �� <br /> Sidewalk <� . <br /> Watcr <br /> (� (/ <br /> ' u- -:. __•<, ::oi. r i i r. :�N.:.;,c il�.�v�� Stfeet '� / <br /> - ' �-�'t , '�'e�-��. . Communica i/qrSs��°�h--.._,ea //-J_ 75.� . <br /> I ec[or's Signature Traffic F' . _� / 3�7<�� '', <br /> � <br /> a-_- I S' / ('' Planning l ,_ /.' S 7 7— <br /> Y� <br /> -6ate� � <br /> � Remarks �i <br /> Note: Original to Customer � <br /> , �o�Y to F��� 10 313 <br /> 1 CapY to Inspector Approve b j — -� , <br /> � � <br /> � L' �' '1 Ga 7YC-L�_CC� � � <br /> � �(`- <br /> f <br /> Daie Appr ved ' � <br /> �� <br /> . , <br /> e9, <br /> � <br />