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everetl <br />� <br />CITY ENGINEERS <br />EVERETT. WASHINGTON <br />APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />The Undersigned J n m F�, l C- c ff r+,- „ <br />Hereby applies tor permission to Cc n�* a l'7 ',� ;,� x �/ � J/,,,, <br />�v��5�� ; ., <br />�''�;� <br />� �,��, <br />PERMITNO. -` � � � �� <br />At the fellowing location 1/ 3/�i W, I b h e r son �` �7 i- i i/P _ <br />(Work to be done) <br />r/�� �.,,..�G <br />�� /'. � �. .. _. <br />�7 ' i i ; !- <br />DRIVEWAY SECTION <br />NO SCALE <br />-- t�', ---� <br />�I'• LIP� /� <br />���..}._— �_3� I <br />—'T'—�I <br />`i — '' <br />��OPV OF THIS APPLICATION TO <br />� l:� POSTED ON JOBSITE. <br />� ��LL ENGIN6ERIPlG DEPT. 259-8811 �I <br />'?•_HOURS BFfORLCOf<'.;"fliU'�ITIGid.. <br />� -' i 5 " % �.e. <br />Remarks <br />Note: Original to Customer <br />� �oUY �o F��e 1. 0� 51 <br />1 Copy to Inspecmr <br />� ��- <br />Sc�.,.er �tU _^ .� 10�--1 <br />�. <br />3� <br />.,k � V�lntc-r mo,n vn,-rf� <br />/. ! ..:. �. ,' `t. <br />The undersigned owner hereby agrees m hold and <br />save harmless the City of Evere[t from any and all <br />claims for damages tha[ may arise because of installa� <br />tion and maintenance of the improvement here[o <br />applied for and further agrees to remuve same upon <br />notice from the City and to replace pub�ic, properry <br />dama�ed�hereby. ,y ,���: .� <br />�� / : s'`� c� <br />Signature of Applican[ / � ' <br />i�, ��5� ������� <br />Address <br />_'�%� - ?�`�7 <br />Telephone Number� <br />;� 2/ /7% <br />Date � / � <br />Fee ���" l��r-i�rr—P�/7���� <br />T' <br />Dep�./Approval <br />Engineeprs � � - � <br />Waterl7 u���ei-fc�� .��� <br />Street � �/,.yh�( <br />Communicatiqn �� <br />r <br />Traffic / /z 9 <br />r <br />Planning � � <br />APpro���c� "!1-�PyS��G / ..— <br />/9 7/ <br />Date ApProved <br />