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APPLICATION FOR RIGHT-OF•WAY USE PERMIT <br /> e�cretl <br /> � �� (11 <br /> CI-�Y ENGINEERS <br /> EVE9ETT,WASHINGTON ?ERMIT�O. �i� . � <br /> � . � _ <br /> � The Uni?rsigned t" ; i� v Yi"Y <br /> i <br /> Herebyappliestorpermission [o {s�(,/,S;K �J'�T �i /� /�Ss��%� � `J�r <br /> At the following location � �O�; J�:.,�- .�-'� i>;- <br /> SKF:TCH <br /> (Work to be done) <br /> S �-`._ %� `- ;�G�-fcri <br /> ' <br /> � <br /> i <br /> �RrvEwAY SECTiON The underzigned owner hereby agrees to hold and <br /> NO SCALE save harmless [he City of Evere[t from any and all <br /> I' . ---- -�'j claims for damages that may arice hecause of ins[alla� <br /> I" LIP �ion and maintenance of 'the improvement herzto <br /> , <br /> applied for and (urther agrees tr�remove}ym� n <br /> notice fr <br /> 30�,.____________._ I 30' �rtf�!he Ciry and to replace blic proper <br /> �.t' <br /> dama Fd tUereby. / ' <br /> ;�.-E���=.�,G�, , _.�.�-- <br /> � Signature o Applic'a/n <br /> --� --- � _r_�!�c u f-'.-.':_._,.�ri� <br /> �COPY OF TH�S APPLICATION "f0 , Address <br /> BE POSTED ON JOBSITE ��^ _ ; Up S <br /> CALL ENGINEERWG DEPT. 259�867 i � <br /> Telephone Number <br /> �?4 HOURS HEFORF CONSTRUCiIOPI� Date -� <br /> � _ - -- -. . . � ' � . <br /> CHECK LIST Fee <br /> Water Valve D�pt: ruVB�§ <br /> Drainage i ���f;_v.,,� <br /> Curb&Gutter Engineers �� <br /> Sidewalk Water . '^ � �N ����� y"' <br /> ..>r_ r ,J r'r i t Street / rvr � -� 'j�y9 <br /> _. .__. .__ . _ __ __ Communications <br /> Inspector's Siyn�;ure - <br /> Traffic <br /> Planning <br /> _. ___. .—__ __ _. _._ � , ' � :..� ' / <br /> Duu, _ ,�s,. ���.��lis„�n, �u��'r <br /> Remar!:s <br /> Note: Original m Customer - <br /> , �°�Y �° F°� 10711 -- <br /> 1 f.oPY to Insper.tor Approved by <br /> Datc Approved <br />