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everen Q�PLICATION FOR RIGHT-OF•WAY USE PERMIT <br /> - e • • �ago9 <br /> CITY ENGINEERS <br /> EVERETT,WASHINGTON PERMIT NO. �J7—/��I <br /> The Undersl9ned�r�� � �%7J�U /� ^i�n c� �N'�aZ <br /> Hereby applies for permission to i`E].0 S J�/l�JG�% � - /7 ' ��/�HA 4 i 1� � i " S <br /> At the following 1�-,cation � J 1� J ��r i✓V✓>O �7 /7 Z <br /> — I <br /> SKETCH � <br /> �1Work to be done) � <br /> ,. �Y � //��/�i i� - . <br /> ^ �, r;J <br /> , :r�1�1<,,_ ,-�*�-, <br /> .i , ;, . �F- <br /> ; ,". <br /> ,. , : : <br /> � <br /> � <br /> � <br /> � <br /> I <br /> � <br /> � <br /> � <br /> i <br /> ORIVEWAY SECTION The undersi9ned owner hereby a9rces to holJ and I <br /> NO SCALE save harmless the City of Everett from any ard ali <br /> � � � - -"'I claims for dama9es that may arise because of installa� <br /> �+I" LIP � tion and maintenance of the improvemen[here[o '� <br /> -- applied for and (urther agrees ro remove same upon � <br /> �30'� _ _ _ _ y3o"� notice from the City and ro replace public properry ! <br /> damaged,Hiereby. � <br /> '�Sfg�i ce'ofAPP�fC t � ������ <br /> � ) <br /> . . ._ . _ _ ( K � �'. 4_ l..i � <br /> �:i-�PY OP l-HIS APPLICATION TO � Addre;s �� <br /> '!' �G: <br /> B� �'OSTED ON JOBSITE. � �� ' �n/ � <br /> � L'ALL ENGINEERING DEPT. 259-881 I I Telephone Num6er <br /> .'�! HOUflS B[FORE CONSTRUCTIONI Da[e�--J-L�7 --- <br /> . � — � ? , , � ' ,. <br /> CHECK LIST — � ����-- <br /> Fce , <br /> Water Valve <br /> Drai�s�e Dept. Approvals <br /> �urb t�Gutter Engineers � l_ /r_.rY�G:�'�._ <br /> Sidewalk � . - . � — <br /> -- � . .'�,.(,•�,. . - . WdiOf /�r. �' - �i1 ._ / . <br /> �� S[fcel�y�/' � �� '� . . <br /> y�v�X�_f✓ <br /> (7 <br /> ____ Ccmmunications <br /> Inspector's Signature Traffic <br /> Flanning <br /> _ .__. __ " i� f ' <br /> �i5ate —.- �-'%'< _��� .t.,� c . <br /> u —_T�,__ <br /> Remarks <br /> Note: Origina' to Cu:tomer <br /> 1 Copy :o File 1 O�O q — <br /> 1 Copy to Inspector Approved by <br /> Date Approved ' <br />