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evcrcfl <br />� <br />CITY F.NGINEERS <br />EVERETT, WASHINGTON <br />The Undersigned.�,f/f-�%% <br />Hereby applies for pertnission to <br />P' the following h <br />�-1'0 ;'T) <br />lon� � i.n <br />— � �fWorl: to be dr:�e� <br />� <br />�=;'n Y T <br />.'-,'r^PL:CATION FOR RIGH7-OF•WAY USE PERMIT <br />i� rti�pr��'F F - <br />ST //_^T 29' <br />N R- O- W <br />� Hd Y �—� <br />AVE <br />w� ' ' EX /5 r//V <br />r ,.// �(.�� ��� � <br />��G /�/'iOk ��•'J <br />�r Gf c' i/ u p� , <br />NO SCALE <br />�---- Zg � - -----{ <br />_ _� LIP <br />�,�..`— � �4. �3°�� <br />Tp <br />. I I I1�,I',:L�..:'L�IG DEP"I�.259�8II11 <br />' ".,UI15 I:::I��Ui;;_ CONSTRtiCTION � <br />[7ate �� <br />_ .`_ �J': <br />PER.MITNO. ���VJVI <br />_ ._ n. �i _ , <br />TH <br />N/_=W CGWCE?ETE D�,V <br />i . . <br />..�--y ' ��,"��'r�,,;,; ` <br />__ � . <br />)SC F1F/1YG �RT/`�I�VE / _ <br />ASPyf7L7) L� . , <br />L V —�� — ._.____.. <br />NO SCf1 LE <br />The undersigned owner hereby agrees ro hold and <br />save harmless the City of Everett from any and ;JI <br />claims for damages that may urise becau:e of im.t,��l:; <br />[ion and maintenance o( the improvement t�,r��� <br />anplied for and further agrees to remove same ir..�r. <br />notice from the City and to replace public proprn�� <br />- dzmagpd�c�eb <br />i`/� �/ <br />�,.i '- i <br />j� - 3(gn ture o A p�c i� / h- - <br />41��.;i�; %�L_fl��:-�L�� �� :. <br />U � Address <br />� ;���;-/}'%i,�+ <br />Telephone Num er <br />� _ � , i <br />�/ <br />� �, /�li(� � . . � � � - <br />! L � ., f l � C:; �1 (',�i /'_. / i / ; , <br />f?ema�ks i�kK�,l.; �,� a 1: <br />� - . , .. !i-:6i%S�('7 /'. �tiC- i:v <br />Not^: OriginaltoCustomer�'.�,.t.'�::� � i �.. . . .� ., . - <br />1 CoPY to File , n��(� <br />1 Copy to Inspector <br />Date i <br />� � �Q G�. S ��` <br />Fee <br />�Dept. Approvals <br />Engineers_ --'�;;r�.,• ��i � - Z,S _ 7S'- <br />Waier L��� �7v 0���✓� -9-�� =Ts' <br />Sveet.^,� �' <br />; � i �- ,�-r <br />Communication <br />Traf(ic - — / � - <br />� - � <br />Planning Z�p S <br />Apn�oveA.b . I .; -�. <br />L.:�-;. .' . . . . . <br />Date Apptoved —� � -�� --� �� ------- � . <br />