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^reretl <br />�� <br />CITY ENGINEERS <br />EVERETT, WASHINGTON <br />APPLICATION FOR R'GHT-OF-'NAY USE PERMIT <br />1.`� {G2 <br />PERM�T NO. �- - <br />The Undersi ned �1 1 -� � :'��: ;�i :�� � <br />g _ �. i l� % l�iC� 1��� i�;'J i� <br />Herebyappliesforpertnissionto �%4�� /'�iLL �-J _:i'1(. �.'� {� L �=1 � � i�if i( �� <br />-:i-;�r,�t 1 ��vn � ����►����_ � <br />At the followin9location -3'� 3� !-1 � i� l /�✓r. <br />SKETCH <br />(Work to be done) <br />I (+LU NU�i,t� <br />� � <br />�. <br />- � _. Tc - �� <br />�.�F' ��LI � . , �. <br />- Y£ <br />� <br />� <br />--=`� ��' � <br />� <br />i__. __ <br />,= . , <br />�., !� I � 1„ �. „ _(Ir i� <br />DRIVEWAY SECTION <br />NO SCALL" <br />��� <br />i-��=h�V�-�`- —.�`'-"t- <br />� � "r OF'fHIS APPL�CATION TO <br />� � �'OSTED ON JOBSITE. <br />.., ', L CNGI�1f:FRIPJ4 DEPT.259�8811I <br />.'; HC�URS BEFORE COtJSTRUi.TIGNI <br />CHECK LIST <br />Water Valve <br />D�-�inage <br />rC�rb & Gutter . <br />; idewalk <br />/ <br />��-. ✓ _ <br />In ctor's5ignature <br />,��;� - ; �- G� <br />ti��� -- <br />Fiemarks <br />Nmc: Onginal to CuStome7 /� <br />7 conY :o File '� n 3 1.1 2 <br />1 Copy to Inspector <br />_ � � <br />".�i, <br />: %;:i� —*- - w°-; f <br />I :�< ;,� +� <br />�."" 1 ! <br />! �� <br />�'j� I <br />I� ��I IJ. G Y L U U 1��. <br />��— �• %� <br />'.; <br />� <br />� ' � �. ,� .._ - � . <br />� � .'�Y, f �:, <br />YI <br />I <br />_�� � <br />15' � <br />f <br />I <br />� 'I <br />� <br />� I I <br />1= � � <br />i <br />.' �. i � .. . . . �; � �.. <br />i�v _ :'a� ._ <br />� <br />The undersigned owner hareby agrees ro hold and <br />save harmless the Ciry ot Everett from any and all <br />claims for damages ihat may arise hecause of instolla� <br />tion and maintenance o( [he improvemen� here[o <br />applieU (or and (urther agrees to �emove same upon <br />notice from the Ciry and to replace public property <br />dama ed thereby. . . <br />� ��a`111�,�,rnt �� �'��s ��(f�V'l���r�; <br />Signawre of Applican � / �y QL�� <br />V'�t- �-/�J �L..0 �' Y';L)�,�IL-l� � <br />Ad reis <br />i � '�� ` C7 �, � � � <br />Telephone Number ' <br />Date — � <br />4':: F � <br />Approv by� �� -� .. <br />-�Ct:t-�'! ��i':t✓::�:.=-.;i ,in ��_ �.-- <br />•-- _-___ — _—. —_.__—_.— -. <br />oace qnnrov�i <br />