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rcw�.�n <br />• `� <br />CITY ENGINEERS <br />EVE,RETT, WASHINGTON <br />APPLICATION FOR RIGHT-OF-WAY USE PFRMIT <br />_Lf�S��Q <br />PERMITNO._(' —i'?.�� _ <br />The Undersigned �( , � �{ � <br />'-;.-C-Ca:ii2_ <br />Here;�y applies tor permission to �, �1� �1 „ , ��{- 7 ,� ' ( ,; . � J� „ � _ � p ' � j � �. `-%,v <br />At the followinq <br />SKETCH <br />(Work to be done) <br />� <br />�� <br />`--� ��� <br />F'OYT .AVE <br />— — — �- — <br />Cr,... :.i.df o�.Hc:. 4. F+-25��{ <br />---- '�'w��l�. - t' <.� r..�n., � <br />.� �- �'- � p . <br />� -al L t) <br />� —� <br />��: .. _ - a �:' <br />o a <br />N F-�I <br />�) f �13 � <br />� ��I <br />� � <br />I � <br />_�__ ___ <br />r <br />! � __�—_ <br />I <br />L <br />i1RiVEWAY SECTION <br />NO SCALE <br />2 - 20'-- .- <br />—�,2�. �----�I <br />�j I" LIP � <br />� 3� �.__ .—__—i 3� <br />� COPY OF THIS A°PLICATION TO I <br />BC- POSTED ON J08SITE. <br />. CALL ENGItJEERING DEPT. 259-881 ! <br />-'�� ili`UR5 �f_FORE CUNSTRUCTIOPIJ <br />CHECK LIST <br />Water Valve <br />Drainaye <br />Curb & Gutter <br />Sidewalk <br />at�e <br />'4 �. ? <br />. C,V <br />a <br />T <br />.A��:') � g': .. . ' . <br />__'_' M H <br />i�� _ , l. <br />_-Y°�_/i�._�!,'., _ �� r.�.. <br />N`tia� <br />ceurn��� a�c cda�r�. -_;, ,;: <br />.f pwys. ..ui�D�. ai,'.�.�u'rr� <br />i <br />Signature '� „�' ,..-';� � <br />Note: Original [o Justomcr <br />7 Copy to Filc �� �� (� � <br />1 Ca�,y to Inspector <br />The unaersigned cwner here6y ogrees to hold and <br />save harmless thc City of Evere[t `�om any and all <br />claims tor damac�es that may a�,;e because of installa� <br />tion and maintenance of the .mprovement herero <br />applied for and further agreea to remo��e same upon <br />notice from the City and to repl;,ce pi,ulic property <br />damaged [here6y. <br />�. , �,: <br />SignaWre of Applic na [ - <br />Address , � <br />, <br />Telephone Number — <br />� /, <br />Date , `� <br />r�� — �=` � . �v t�T-� <br />/ <br />Dept. Approvals <br />6igineeis_ <br />Water� w �0�-/1,1verSC�a ,Q �d f!s h�n � <br />;-,", ��: �U�• Street `� <br />. .:,,� „i�: „ ��(.� '�� / ` <br />,;�.H�:JI\..; COfY1R1l1nICdi10115 `'-�t��y��, _ <br />�, y:r, „� . <br />Traffic . % � _...',� � _ <br />Planning � i / � <br />_� L. <br />APProytd b`L . � � i _ <br />- '---- �� - , �=�� . - <br />Dat�{ Appiovr.d � ' <br />