|
evcren °��'���CAT�ON POR RIG1i7OF•WAY IJ�E Pi_RMIT �
<br /> � `i0377 ,F i��1���;;
<br /> � 7 � �
<br /> �/I �.
<br /> CITY GNGINEERS .
<br /> [VEPETT,WASHINGTOiJ PERA1IT N0.
<br /> - . .�-�. � � ' � �_-- �
<br /> The Undersigned ''i�' ,'� '��! �' " \' �" '
<br /> Hcreby applie;for permission to �'��'✓^! � �,�� %� � �� _ `� �� �-�����'L.%
<br /> - - �
<br /> At the following location ��i -9 . �� ��� '�` �' - /� : _'��-L ".� i' � f" .:i� -� ^�.-. ��. �
<br /> �---= � � ` -----=-
<br /> SKETCH —
<br /> (Work to be done� i
<br /> � �.
<br /> --_._..___--'._...'-'._.___�...---------- t�',�l/��:� �'i �j_ `;_��;' . .
<br /> I _._. .. . ....}'G�+/' • .
<br /> �,'i i(.-�: � � .
<br /> i � i,
<br /> ! � j�
<br /> __._ I
<br /> ___---__ ------__ _._ .__ ___ ---- .
<br /> ,
<br /> �__ _ _ i ^ � ,.�
<br /> \ �
<br /> ��; ,..�.; ` ',.l
<br /> � ,:;, �y
<br /> , .. . � �•�
<br /> ..���__...__._ . . _ ��� I � � ' .
<br /> _"___.__._ ..—_...._..'_'._. ...
<br /> ... __. .__ . . ; c� � �
<br /> �
<br /> I i l l i . .- .
<br /> �,�.. ,�� � ��.�
<br /> I' � � , ' � .
<br /> � ( - ,I _ ����� � i _
<br /> ________ _ _ =� � �
<br /> __ ._.__. __ _ � ,
<br /> \ J ! �
<br /> I + '
<br /> /i�,�l` �� � �
<br /> i � �11 � ,
<br /> - �-------- � ; (
<br /> � CQ'V'>;. ,;� . .:.., , L �
<br /> � : `:
<br /> � ORivEWAV SECTiON The undersigned owner hereby a9rees to hold and
<br /> � NO SCA,LE save harmless the Ciry of Everett from any and all
<br /> � G:i ------ -- "��-'{ claims for damages that may aris�becau,e of installa ,
<br /> ��' L�P � tion and maimm�ance of the improvement hereto
<br /> applied tor and furiher agrees to remove same upon
<br /> 30' 30" noticr from ihe Ciry and to replace public prupr.rty
<br /> --� ------�----�-�-� �
<br /> �
<br /> `�, •.' da�9ed thcreby. .. . . `
<br /> ; �.
<br /> ;��� . �
<br /> , S Signawre of qpplican[ . ��
<br /> li
<br /> V i�i� .� ' �����. �j ,'::.,� . �-.�._�:
<br /> COPY OF THIS APPLICATION TO �iN / ; Address .
<br /> BE POSTED ON J06SITF, •� •�, � �% ;"",` - %:' /i'
<br /> CALLENGINEERINGDEPT. 259�8817 �'� �� TclephoneNumber
<br /> � v::i � _ ... .-.1''_-
<br /> 24 HOURS 6EFORE CONSTRUCTION ��, Date , �/�/ �
<br /> -- ° _ ,�--__��"-�7`1.f�,�-
<br /> CHECK UST Fcc �
<br /> Dra���alve � DB t. Approv�ls �
<br /> 9
<br /> Curb&Gutter Engineer _ . _ !/� / �,
<br /> Sidewalk Watcr�p,f- ia_ti , /1�� �- �yyJ � .
<br /> �.� �i ;�'� Streei����,,, � — :
<br /> �^^� �J Communicati >, ' '�� l �
<br /> Ins�.F, tor'sSi nature �� �� `r' ,
<br /> , 9 T�affic� ,.�'``.-�'. !�- ;' .
<br /> i
<br /> , �- �. ..�i0_ J �. � Planning � � � / ;(/ ,l� ;� •�!� _;(F, .
<br /> /
<br /> -bate
<br /> d �. l� f/� . . ' �'6
<br /> l
<br /> Remarks
<br /> Note: Ori9inal to Custoner -
<br /> 1 CopY to File �O'J 7�
<br /> 1 CopY to Inspertor � � APProved bY �'��� 2 �n ,.,/ -
<br /> _. . . ..i,. . i �
<br /> — ,�-�'�y� .
<br />
|