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v <br />evereft <br />� <br />�ITY ENGINEERS <br />EVERETT,WASHINGTON <br />AF'PLICATION FOR RIGHT-OF-WAY USE PERMIT <br />_li��l�l (/�• 7 <br />rv��� ���. <br />PERMIT NO. % � - %.� <br />The Undersigned _ J r, m S /l 1 �i �f <br />Hereby applies for pe� mssion to r O n s rr�_tt j' v,i � n c� h � l t `��.v ' o n n ��� <br />�„ �ri�i .�•/�/�%% —/i,4 — %is7'�/ �� <br />At the followir: Ioca!ion <br />i <br />F <br />_ _.Lr_/-1••�'. 1N � 71� /J, a'F N. r�i. of �nfercitu avP <br />JI\L I V. � <br />IWork to ba done) �� �"� ThITE(ZC. 1 T1( ��/ � <br />!n� ��.l) �2'� I '�. <br />CulvE�i � I ; i <br />� �— <br />r,/�.. \ � <br />ph. — <br />txlen�l ���� te rnc-�T <br />FxiSf�nJ �n ��rmci-�t. <br />I — � l U+ :. <br />�� `� ��i <br />,., ,I�I <br />, � y e' � � <br />1f— <br />4�' — <br />IA'pt'_ : �, Zti I <br />' ' '� I <br />Fq 1 L � <br />� <br />J I F G <br />Cdr u UF �\ �- <br />u>y/�nll�.� �\_�. �j I <br />— -�•. I �,5. I � �-- <br />�.r -�..� r <br />-�----- _::'--=---_ .. - <br />� .` "' <br />� L C_/. Tyfn9 i.i�� y � i r,.: . .. <br />�, �. _� I <br />! <br />-_._�__ ______ - p/� i <br />u/ Inic�c�1� ,�Iv� <br />• t <br />DRI�'EWAY SEC710N <br />NO SGiE <br />i <br />-- 2' � ---�--'� <br />��' <br />f' LIP � <br />--- ' <br />30'�„—_—_..._— —_ _.__. I 30" I <br />�1' �1 <br />COPY OI 1fiiS F,PPLIC.11lOiJ lCi <br />6E POSTED GN .IOBSITE � <br />CALL ENGIN[[RING DEPT. 25&SS11' <br />.''; Hr){Ifi'� ii!-�OREG)i,��liUCiIUfJ� <br />CHECK LIST � <br />Water Valve <br />Drainage <br />Curb & Gutter � <br />Sidewalk � <br />Signamre <br />Remarks <br />Note: Ori�inal w Customer <br />, co,�Y �� F�i� <br />1 Copy to Inspeclor <br />�.��a�� <br />Do Alct Scc,�_ <br />i"'/��'r,. �_� ��ie�it, <br />.�t`i'�r� <br />J <br />� <br />\ <br />The undersigned owner hereby agrees to hold and <br />save harmless the City of Everen `rom any and all <br />claims tor dama9es that may arise because of installa- <br />tion and maintenance of Ihe improvement hereto <br />applied ior and (urthor agrees to remove same upon <br />notice from the City and to replace public properry <br />damaged thereby. � _ �(� <br />Srgp wre u pplicani' - <br />n j 1 h—� `�+ � j�s S�_(� tl. l 1�d'O I � <br />Address <br />�-I �1 s � 4. � <br />Telephone Number � <br />� - 8 - �7L� ; . <br />Date,// <br />TP � l, ��� -FiRc� f i� �- � o �7 te <br />Fee <br />Approved by <br />D�te Appraved <br />� <br />