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r APPLICATION FOR RIGHT-OF-WAY USE PERM17I7 _ +� <br /> , . ev� 1�32� �I <br /> i <br /> I <br /> CITY ENGINEERS � ^7 � <br /> EVERETT,WASHINGTON PERMITNO. ��3 � /?�/ I <br /> I The Undersigned ��� �I / /�I �t I T T I <br /> I Hereby applies for permission to rU�v 5 r�� i r T n r ,�N U.� Ll ����) � <br /> 7Tf� r I�f-INFUi�Lt i� r/�Nf7P ►� � ! <br /> At the following Iceation /2 /7� . H� I///1'r (�Vt= . '� <br /> i <br /> i <br /> � SKETCH o �--_._, r J _ __ _.�----_.-� I <br /> j (Work to be done) �i �-�—" � � � �--- I <br /> � � � ______l_`LLZLi14.7�.��f�_�._ `C I <br /> � G_ <br /> �i,VC, Posr Tlv�-IiF;L LIL'HT PI]Lt <br /> ' ' �� � Llit,f;.t�-11n z Plil= <br /> ; /!�O'"� / ' � � l�c:.� u>a,a�n.iG Zcuic' ' <br /> �E�-G.�CAT� (_G,s�l�/n/C' -- -"�-2;2��.!-,.C�11�---- � <br /> I� �C,v� �ZGM . Vu�TG�i1 � i � i <br /> TU r�El.�.�/TT �NO �E�/Ov o�`% � <br /> C ?-?,�<.n/G �L'�rt=�C S ,+d� - <br /> ,.:.�:�M f/E_Gti�Ti � � �� <br /> —16� i <br /> � ivew c .•+o�.v� lLO l ' <br /> i <br /> /UO%�'% Z Zc,vE <br /> r7LC S7�EL I NOPy , <br /> � �GuPC.�NGS T�,ZENG�D �?r,,<,r;.vc .�-/FTFiC � <br /> I � � <br /> 2' ST��L PIPF FI�ANINU � ATT;aLH� D r[7 �aLl) C . �_:; � ! � G <br /> ,� � G UL T5, <br /> I <br /> VFRTIL/�L CLL� l�AN1 �. � [�Nv� S UlILL t3� su�- <br /> , ., y <br /> 9 G �1 i�oRrco r�� 5r��� srrr��� <br /> ( /�ll M� Tt !�l�lL �r� yl'PROVt�. ! <br /> I�� DRIVEWAY SECTION fT The undersigned owner hereby agrees to bold and I <br /> NJ SCaLE ��� save harmless the City of Everett from any and all � <br /> claims for damages that may arise beceuse of installa- <br /> I � '�!� tion and maintenance of the improvement hereto �' <br /> I a�l applied for and further agrees to remove same upon <br /> �-��--�- ---�� notice from the City and to replxe public property I <br /> I � ' damaged thereby. ; <br /> /( ,/ �, 'f��� �� �� ' <br /> '�, Signature of Applicant ; <br /> iV �o; 3u — l/� .g�� :.� . i <br /> � �COPY OF THIS APPLICATION TO� Address <br /> � BE POSTED ON JOBSITE. �� ���' � ' yU�Y i <br /> Telephone Number <br /> CALL ENGINEERING DEPT 259�8811 ��_r _�� ' <br /> 24 HOURS 6EFORE CONSTRUCTION Date �� , <br /> - — - - _ _---- - - -�„•---r�.:�,r._ A/� F� I <br /> ' CHECK LIST � ���f�` � ` � UU �'� Fee ' <br /> Water Valve _, De t. ppro 5 ! <br /> � Dreinage I l- 3 - �5 // ' <br /> . Curb&Gutter � Engineer � ,.�'� � <br /> Sidewalk Warer �_ �I <br /> Street � <br /> I�,�rl /��,✓ Communi t ns � �c.I'> ��'�-�a� <br /> tor'sSignature Traffic �� ' <br /> � i'_ / �7 _ 7 � �S- - ,� Plannin - Z7J 'il <br /> ��. <br /> ate - r v r��, <br /> - � <br /> � Remarks - � <br /> � Note: Original to Customer <br /> 1 Copy to File ��3 2 Q - - �1 . <br /> 1 Copy ro Inspector �e'�'��f��_� �_ � . ' <br /> — r_ . .�r-' . <br /> Date Approved ' " �` � <br />