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APPLICATION <br />everett <br />e�--���---� <br />CITY ENGINLERS ' <br />EVERETT, WASHINGTOY <br />RIGHT•OF-WAY SE P <br />11644 <br />-�: . <br />PERMIT N0. ��r �^.iU�-.� <br />The Undersigned - 1 - � _ - , ._ - �_ � , - � , .0 .� - - �. Y � i;:' • .� <br />Hereby apPliesforpermission to= -a-�.:__._, ; - _'.c ,�<.. „-.:.:..��,.;.,,:,..,...,..,_.,,.......>,.;..,v-"r=�iv� - -1 .� �; -r�'-'-� <br />1�—� - ✓ ✓� ,rv �'" :a. , -�ti, a�% , <br />fn�...�- � ' '. ."' i %�R��°K�N. ".4:_i_ r '_ ' i=r� r'c5r �: �/`I 7u . ,_ , ' '_r ,_,.J i c � <br />At the f'ollowing location � " _ � � � - � � v � <br />(Work to Ne done) � j ��' � � ` <br />DRIVEWAY $ECTION <br />NO S�:4LE �J <br />�-- _- I <br />I�� LIP <br />30'� I 30" I <br />—T —..� <br />COPYOFTHISAPPL�CATION �0 <br />PE POSTED ON JO�SITE. <br />CALL ENGINEERING DEPT. 259�8871 <br />24 HOURS BEFORE CONSTRUCTION <br />CHECK LIST <br />Water Valve <br />Orainage <br />Curb & Gutter <br />Sidewaik <br />Inspec[o Si atur� <br />g-A�R��-�9 <br />are <br />flemarks <br />A/� ��"rr�`'� SrcJ r 116 4 4 <br />� •- _ __- -;- -.. <br />The undcrsigned owuer hereuy agrees to hold and <br />save harmless the City of Everett from any and all <br />claims tor damages [hat may arise because of installa� <br />tion and maintenance of the improvement hereto <br />applied for and further agrees. to remo�re same upon <br />notice Trom the City and to replace pubiic property <br />damaged thereby. . . <br />�- , , ii <br />Signature of ApP icant � � � <br />< , .. ; <br />: ,- ..._.. . .:_ � - <br />-- - -_1� J:J�", <br />Addre'ss - <br />__. ..... ..: , <br />� - r r <br />l'elephone Number � i� � � <br />� :� - �.a _ _ 7 _J - <br />Date <br />/„ _ _ � . <br />Dept. Approvals <br />Communications <br />,. , _ �, ..� ..,, .,_ ... . .. <br />• .:_ . i.. ]:�. _ I . <br />Approved by '�\. �1—t' _ . � <br />i :•t3� �.� l.; <br />INSPECTOR'S COPY Date Approved ' � . . -.- _ <br />♦' <br />