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everetl <br />� <br />CITY ENGINEERS <br />EVERET-i. WASHINGTON <br />APPLICATION FOR RIGHT•OF-WAY USE PERMIT <br />10456 ��,,���� <br />l � / <br />C � /L <br />� /� ��': <br />_ i <br />h <br />PERMIT NO. % r �� �-' <br />The Undersigned _ C c! v i-, L :� J� r� �� �l � <br />Herebyapplie:forpermissionto_ lo���1r� �Y� AZ � Frn �� z�- '� r/n r S�(.{/ _ <br />At the following location 7_ � 2[� L� o n o rc-1 J) r. <br />(Wark to be done) <br />y,� <br />�_L E O N A iz J O R, _ <br />� , r-_ � . ._� <br />2 <br />DRIVEWAY SECTION <br />NO SCALE <br />�--- -------� <br />� i�� LIP � <br />30'+_. —_.__��_3� <br />COPY OF THIS APPLICATION TO �i <br />9E POSTED ON JOBSI7E �'� <br />� C,�LL Ef`�1GiN[ERING UEPT. 75&861 I <br />74 HOUI?5 OEFORE CONSTRUCTION I <br />`—_.— - - -- -- - -- - - --. . <br />CHECK LIST <br />Water Valve <br />Drainage <br />Curb & Gutter <br />Sidewalk <br />Inspector's Si9na[ure <br />Remarks <br />P�G vCn�N <br />�' (l�:_:<:..�:.,_ <br />q��_r.�7F. <br />/L <br />The undersigned owner hereby agrees to hold and <br />save tarmless Ihe City �f Everett from any and all <br />claims for damages thot may arise hecause of installa- <br />tion and maintenance of the improvement hereto <br />applieci for and further ac�rees to remove same upon <br />notice from the City and to replace public property <br />�ae [here Y � I�C�-^-'c�'� <br />S g�ture of Applicant ,r� _ <br />� � v ,� eo,-,.�._,-�' <br />Address <br />z, �--../3"7 6 <br />Tele hone Number <br />�f— �3-76 <br />Datc ,� / <br />Fec �/�2�E�`- _ <br />De t. A roval <br />Engineeprs ,/ �� <br />Water n." .�.•• �� /`7¢errC�o /�-9/%i <br />Street ,�x= . � <br />Communications / - �' <br />Traffic " � iG� <br />Planni i 7�• <br />S '�w e� /I��' ,7�,,.��Ptu. .-11f <br />Note: Original to Customer <br />t conv to File 1�? Ll F <br />1 Capy to I nspector - �� � Approved by � <br />l �� � /� <br />— "`.< 7 _1i� ^/1� <br />Dotc Appr�Bd <br />