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� ,._�`_._ . , <br /> APPLICATION FOR RIGHT-OF-WAY USE PERMII <br /> everetl ., . - <br /> � . .. ..._ _. 4 <br /> CITY ENGINEERS <br /> fvr_RETT, W�SHINGTON PERM1IIT N0. <br /> Th�� Undersigned_ - � <br /> Ib�i��byappliesfmpermissionto � ��. . � ,., - , <br /> ;\t the following location <br /> _ ___ ._ <br /> j i.� ;�" <br /> �.:I[GTCH � �------�------ <br /> i 1York to be dona) <br /> . . . . ��..s_..___._�_, /, <br /> - . _ ..�J6/� �4/Y�.Ft1El.l�c'_""'��^� '._ �. . f <br /> `� I1jI SQF`G �;��o� � J� � <br /> � <br /> I�f�;' �v I-�Ip�V fi,00�. / <br /> � _� � <br /> ; � <br /> ; � , � <br /> I �� � �E--`�C'C�l! vJ/�+.k <br /> /��' .� <br /> , �� � / <br /> , � � �� <br /> � � 3r.�'��i,tiii��� <br /> � � � <br /> � 7,Ons+'�'�� <br /> , <br /> / <br /> '���� � �� ��� ��� <br /> , .- <br /> f�l �. <br /> ---�,, � � <br /> Q _ _ __.c,��i�L ����� -__s_=�____ <br /> M113� $t6z,. tfNY. �,� <br /> �� � <br /> �� V `�L _����� <br /> _ � <br /> '� � }.7TE.Ei' �l� /jV[• —�^_ �,,,� _"_!-�_. <br /> .L-----=_____ ..� <br /> �----- __ <br /> _ _ _ �, <br /> ORIVEwAY SECTION The undersi9ned owner hveby ayrees to hnld and <br /> NO SCALE save harmless the City of Evere[t (rom any ard all <br /> '� L.��� � �`j claims for damages that may arise because o(installa� <br /> � <br /> . � j i" �ip �—�l tion and maintenance of the improvement hereto <br /> .y�,�� - 1 � - "" i„�.� aPnlied (or and further agrees ro rernove same upon <br /> " '�' '^ ^� ��otice from the City and to replace public property <br /> rLini�Ged thereby. <br /> S�qnaiure of Applican; ' -- - <br /> _ ___ '�.:IAf � ��-�/S �'�{l� <br /> ... 1:I i� ,��.i���IJ�_r,il�r.'. 1,,! Address � <br /> _ __ <br /> �iSTEDON .1pBSITE. � ' <br /> Telephone Number - -- <br /> �. [NGINEERING DEPT. 259�8E311 i ; �� _� „ <br />' iURS BEFORE CONSTRUCTION� Date - -� <br /> �.!IcCKLIST Fee � �� --- <br /> C:,iter Valve - <br /> Diainaye <br /> Dept. Approvals <br /> Curb& Gutter Engineers_______ _ <br /> Sidewalk � � -- <br /> Water <br /> —— -- -- --- ---- --- <br /> Sireet <br /> Communications_ <br /> Insp o sSignawre Tra(tie <br /> ,3 - A PP�r� � / l Planning .. <br /> -bate — <br /> Remarks -------- _ <br /> � � � ' � - <br /> ApProved by � . �- <br /> fi.�t,�l�i���i,.,: _- --� - -- � � .. <br /> �� <br />