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everetl <br />. � <br />CI'fY ENGINEERS <br />EVERETT,WASHINGTON <br />APPLICATION FOR RIGHT-OF-WAY USE PERI`�IT <br />The Undersigned � � � � <br />Hereby applies for permission to � <br />At the following locati <br />�Work to be done) <br />�RNEWAY SECTION <br />� _ — NO SCALE � <br />�I LIP <br />I�30�.� I 30.. �. <br />��i i;OPY OF THIS APPLICAi!CN �f0 <br />''� E3E POSTED ON JOBSITE. <br />�� C;1LL ENGINEERING DEPi-. 259�8817 <br />��. :i�', Ii0UR5 6[FORE CONSTRUCTION <br />CFIECK LIST <br />Water Valve <br />� Drainage <br />Curb & Gutter <br />S�dewalk <br />G-- ��.i.� ^.-, <br />In;yec Signature <br />�3 0�� ��79 <br />l�ate <br />Remarks <br />� <br />. i3�� ����{rt �,;.�. <br />F�Y > t �:iAxi r1 <br />� .T_ �...(.�. �� � � Mi+ <br />1 ! <br />� j ������ <br />� <br />��<i <br />(,. <br />" '��:a <br />_ ••`1*^` <br />PERMITNO. ___ <br />i�he undersignad owner he,reby agiee; to hold and <br />save harmless [he City of Everc[t fram any and all <br />claims for damages that may arise because of installa- <br />tion and main[enance o( the improvement hereto <br />applied for and further agrees to remove same upon <br />notice from the City and to replace pu�lic pr�perty <br />damaged thereby. <br />Signature of Applicant <br />Telephone Number . <br />Date <br />Approved by <br />Date Approved <br />.`�t it <br />4 �Y�'� ..�..Y <br />1�TI..6S��••t�w{41G�':i:pFric'r.Ssi�'�••\T 4nTn.r�nv♦ n. ...��...i•. .•.'::.... .-..-....' <br />6MR1'� T'-.:,: � i . . . � <br />�„ ! <br />. .. . _ �' i -. . . <br />Dept. Approvals <br />3 <br />. . .. . .. . t���° ..t�; ..�t� <br />Li. . _ <br />v� <br />a <br />�ry.y � 1 (�`. <br />