|
evcreti /'�PPL�CP.T10N FOR R:GHT-OF-WAY US[ PE 1`,11T �
<br /> � J.�3 (P �,iG �
<br /> � � � I��,
<br /> ✓'.i 1
<br /> CiTY ENGI."JEERS � � : . �
<br /> EVERETT, WASHINGTON PERMITNO. ' �- '---
<br /> '�� � . � , � � � ,
<br /> The Lndersigned : �� '•�i�'C-'�` ! _ .• � ._ ^' i.r:"'
<br /> Hereby apPlies for permissior� to_ �.%'�1/r T (�'F'-� --i'�:.=� -: <' j-;,,, ''� :' l',�!..�
<br /> - --_ ._�., � .
<br /> At the follow�ng location .'% �S i/ �%f_.•i �f ` '�/-;� _ �__ '=,:':_,��." � � =-�"- _ �, i
<br /> . _'__. _._ .. ��J'
<br /> SKETCH
<br /> (Work to be done) �t
<br /> --�-'--�-- — ' G�t.%1�`�,` r� r :� _ � ,
<br /> - —�------_...�---- , i _ . _.,
<br /> �',vt% '. �.
<br /> I `' � � • �
<br /> �r�, = ;� �
<br /> I
<br /> ' f
<br /> ,
<br /> __ � �I
<br /> "__'_________ _"___..._ � .
<br /> �--.___.. _-----..... .__.._ . _. .
<br /> 1 �
<br /> I� .����J ��_� i � �I �
<br /> .._.--------'-----------._ ._ I � ' + _ .
<br /> . i ' i1 I
<br /> ,,l- r. , i
<br /> - - y ��y - -� .
<br /> ( + , ��:� �,
<br /> f'�� :` � ��\� .
<br /> � � .y,l ;
<br /> --------
<br /> , ,. ,. � -
<br /> _ - ------ ___ -
<br /> � ; .
<br /> I;::,��
<br /> ., �
<br /> � �� Q ' �i !
<br /> -- 1- _ _, �
<br /> i � � I
<br /> - �
<br /> ,
<br /> � �:r�_.
<br /> ca,��;. ,� _,
<br /> � �,;�f �
<br /> ,
<br /> DRIVEwAY SECTION Tlie undersigned owner hereby a9ree:to hold and
<br /> � {�. NO SJCAIE save harmless the City of Everett from any and all
<br /> I G� �— --'j claims for damages that may arise becawe of installa�
<br /> +p' LiP tion and mainte�ance of the improvemnnt hr.reto �
<br /> I 30" I ? 30" I applied tor and further agrees to remove same upon
<br /> -- __ __-'� _
<br /> t'--�t'���- � � - ----�- --- - � � � �'1 noiicG from the City and to replace public properry �
<br /> <. ��'y darnaged thereby. _. , � .
<br /> t' i;tl l. __ . - . --�'; � .
<br /> Signature af Applicant �^ . � �
<br /> - —� '1� �a / ' j;-,�. '-�:- . _..�
<br /> COPY OF THIS APPLICATION TO ��' I� � Address �
<br /> BE POSTED ON JOBSITE. . �`' { 1�� �'�7 - 1�� i�
<br /> CALL ENGINEERING D[PT. 259�£3311 ,�,� 1: TelephonqNumber
<br /> kt - - �.
<br /> 24 HOURS E3EFORE CONS7RUCTION ���.�' �'� Date �� ����� �
<br /> �` C. i.
<br /> CHECK L�ST Fee �
<br /> Watar Valve � y
<br /> Draina e Dq t. ApproV IS--��, � .
<br /> 9 � .�
<br /> Curb&Gutter Engineer ( �,
<br /> Sidewalk Wa.er� rLy . /�PA -��c- ��Q �f
<br /> � (:`� • '• Street��._��
<br /> i � � !
<br /> ��+. lJ
<br /> CommunicaY � ''7Yf
<br /> � In •tor'sSignature Traffic f",` AE� � .
<br /> _ �
<br /> � �� � � Planning -. � , / ;% . i � /„
<br /> -6a�e — �' Y•
<br /> ,6
<br /> Remarks
<br /> Notce Original to Customer
<br /> 1 Copy to Flle '�Q�"]'] — .
<br /> 1 Copy m Inspector a � Appr�ved by /j ,Z '
<br /> _F�, �f /? ��
<br /> DJIQ A�IPlDYI:(�
<br />
|