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APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br /> everetl �dW �+ 1 • •, � <br /> � _1 y ,� <br /> CITV ENGINEERS ' 75-2 <br /> EV ER ETT,WASH I N GTON PE RM IT NO. <br /> The Undersigned �d ��/�O <br /> J{�erebyappliesforpermissionto n�)/ � ��^ AG/N//VG ��/vL `Upp�p l /JJ,�-iT.r <br /> I/?�lJN��Vc� f�;'rr:t __ :� �` I� l .'/t� U�. � r.'-.� C (_'�Rl� l :l);�. }�!L�� ✓[-� �� �. �,.� <br /> At the following Ixation �� � /� JFG'✓%T: �VL� �L�!!!� _ ,r/ ��%�� -�l�(_-, � — <br /> SKETCH � <br /> (Work to 6e done) <br /> D� <br /> Fa,r_= 5F <br /> Aln/N/i11 G B(�I LD1PdE, <br /> L � .0„ <br /> I <br /> 0 <br /> ( P/Pf COLOM.N �TY.Y� I <br /> � � 8�3�� I <br /> I <br /> �IDFWRLK <br /> - (E�I3T.) <br /> ����� /' 7%z' <br /> 2,� „ <br /> F,�vtir �rE�,y � siD� viFw ���P,��� <br /> DRIVEWAY SECTION The undersigned owner hereby agrees to hold and <br /> NO SCALE �C save hartnless the City of Everett from any and all <br /> t claims for damages that may ariu because of installa• <br /> (`'� tion and maintenance of the improvement hereto <br /> J V N� applied for and further agrees to remove same upon <br /> 3 " _ 30�� ,/� ) notice from the Ciry and to rep public pr rty <br /> � � � \ - , damaged thereby. <br /> \ � � �r AlddresseO/�P��` f�ew� <br /> COPY OF THIS APPLICATION TO y� � / � � � <br /> BE POSTED ON JOBSITE. � �� V� 5 0 3S • 5 <br /> JC-� Telephon r �' <br /> CALL ENGINEERING DEPT. 259�8871 I 3' �,/� `7 <br /> 74 HOURS BEFOR[ CONSTRUCTION� �i�� Da te y0 �EE <br /> CHECK LIST Fee <br /> Watar Valve ep 1 rov 5 ' � <br /> Drainage 4 � y,�'� <br /> Curb&Gutter Enginee �_ <br /> Sidewalk Water <br /> Street _ <br /> Commun'c ��• •'-�p <br /> Inspector'sSignature Traffic i �6 7S <br /> Planni �` �' <br /> at�—_ / <br /> Remarks � <br /> Note: Original to Customer - � ` <br /> ,�oPy �o F��e 1013 8 <br /> 1 Copy to Inspector Approved by <br /> Date Approved <br />