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- Feveien <br />�� <br />fY ENGINEERS <br />ERETT, WASHINGTON <br />APPLICATION FOR RIGHT•OF•WAY USE PERMII' <br />10847 <br />PERMIT N0. �J,� �� S� <br />; Undersigned _[�'%2 Tl-}V �'` � h'f�'!./UV QL/J <br />�eby applies (or pennission to _C dJA! ST/t Ul7 1'-� �S� iq SpN ��.T D�Lv <br />i' <br />the following location '% �7i0 /-�I l,�it �YN (� [� � <br />�rk to be done� <br />S�% <br />d.� to Gol'i1 i`fv.� <br />��`% �y <br />OR�VE�NAY SECTION <br />NO SCALE <br />� <br />�" LIP <br />30" I_ I�30" <br />PY OF THIS APPLICATION TO <br />POSTED ON JOBSITE. <br />LL ENGINEERING DEPT. 259�8811 <br />HOURS BEFORE CO�'STRUCTiON <br />ECK LIST <br />ter Valve <br />iinage <br />b & Gutter <br />ewalk <br />�ector's Siq�ature <br />e - <br />iarks <br />e: Original to Customer <br />1CopV�oFile '�08�7 <br />1 Copy to Inspecwr <br />/-}-TT�CN Eo <br />The undersigned owner hereby agrees to hold and <br />save harmless the City of Evere[t fi om any and all <br />claims for damage: that may arise because of installa• <br />tion and maintenance oi ttie improvement hereto <br />applied for and further agrecs to remove same u�on <br />nutice from the City and to replace puhlic properry <br />dam "ed"thp reby. /� <br />LG�7'���tJJ.yz as��r,t' <br />SignaWre of,� plicant <br />%Q/�i�"�,�e ��. 9�3z03 <br />Address <br />�5.3- 3tsz <br />Telephone Numt,cr <br />���� <br />Date . � <br />�2 .'JZ� <br />Fee <br />Dept. Approvals <br />Engineers � G/ r/.�_i� . ) <br />Communications <br />Tratfic <br />Approved by <br />