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everett <br />� <br />CITY ENGINEERS <br />EVERETT.WASHINGTON <br />The Undersigned . ) r mi <br />Hereby applies for permission to <br />At the following <br />;Work to be done) <br />I <br />�—_______ <br />APPL�CATION F)R RIGNT-0E-I'VAY l SE PERMIT <br />1���Q la��/ <br />3 J /J�� <br />PERMITNO. �' ` � <br />� •� C': .:� In/ , / /. /, r�_- .o� �s��i !7,- i ✓ P <br />2 U' <br />I'j�„•� <br />t�- <br />� <br />V'�� ��, <br />� ` h r�� <br />�� 7 �' <br />\ <br />� <br />��I <br />� DRIVEWAY SECTION <br />NO SCALE <br />�.-- t�� . --{ <br />. I�—jl�� LIP <br />30'� �30" I <br />�1 <br />� COPI' pl� l�ill3 i1PPfJCi+� I(,:. i(; � <br />' LE POSTLG ON JOf3SITE. I <br />CALL ENGINEERING DEPT.259�8871'� <br />��n i�ouFs eEror�e cr�r,�s rr�u���iorv I <br />� � I , / !:3 <br />Remarks <br />. Note: Original m Customer <br />! i couY to F�i� <br />� 1 Copy tc Inspector <br />�`) u J t'n �F <br />y �:... L:.. _.,__ <br />!_ i_,,. , <br />3 <br />x wfitrr f�l.�i� VO�IP: <br />% tC'�, �, t��� �. <br />The undersigned owner hereby agrees to hold and <br />save harrtiless the City of Everett from any and all <br />claims for damages that may arise because of installa- <br />�i �(t �' .'� tion and maintenarce of the improvement here[o <br />applied far and further agrees to removc same upon <br />notice fro�n the City and to replace publia property <br />da ag�d thereby. � }-�� � � <br />i `' <br />Sgnawre of Apphcant � ��� <br />� , �� �-7/. �-�� '9i�'�i: �� <br />Address <br />"'� i - � ']'S % <br />Telephone Number/ <br />%�! � �i� <br />Date / / "� % <br />—_ ?���--�(;,-`_ ��,(, 5�7�jU <br />CC /r� � <br />D� t. pro� <br />` �-- <br />Enginee / y <br />Water SCl, e �i� <br />Street %` `�' � <br />Communication �� <br />Traffic .a �- - �, . <br />Planning .. � -i > - n, ., <br />10 4 4 9 AP�,o� b � <br />��� �5/��— <br />Dat� Ap roved <br />� <br />