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everett <br /> APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br /> 10467 ` <br /> � <br /> CITY ENGINEERS <br /> EVERETT. WASHINGTON PERMITNO._ �. - ��' <br /> The Undersigned $ 1 ff'� r � /`(� iv c /1 <br /> Herebyappliesforpertnissionto rn �eP cr�} 'o � �e � � �-,P 5/ � D�w <br /> _ f <br /> At the following location 1 3 ? 2 C-Zr��_cl A � <br /> SKETCH <br /> (Work to be done� ��� •�, i: <br /> "��y 7p ,1976 <br /> UTILITY DcP;1RTME�;� <br /> _ _ ------ I_ 1 . I <br /> --_ __ ;; � - ---- �, <br /> I I � � <br /> , ___.__ _... _..--__ �: I � ` �Ci <br /> iI � <br /> _ _ 1 . � <br /> � � �� � <br /> t32' <br /> - --- f j �I <br /> i <br /> -� �G.3' --�' -.�. -�'.�.. � c <br /> I? _.--— . .._ . --- 1 ' � I � S� <br /> . _.—=_.. .JA '.�._. . _J_ _'_t.� � � ` \ <br /> J .y�^ ! <br /> ' _ . .. . '� . : .: I ,, . <br /> -- -- - --- -- ------ -{ ; � 1 -r_ � <br /> I I �� <br /> , �. <br /> . .� ,: -- <br /> f`I e .. . !v . �Jb , CJ' <br /> � r� <'.9' �s : <br /> �[�ti..1�+-ti� � � ' '. ' �I c . <br /> ' S��n�7G � � v <br /> ,'L � I ' � <br /> , <br /> , ; <br /> s�o -�� � j <br /> �'-�� � <br /> DRtvEw4r SEC7�ON The und?rsigned owner hereby agrees to hold and <br /> � �S�` � save hartnless the City of Everett from any and all <br /> f'c claims for damages that may arise because of inualls <br /> I � 11" Uv tion and maintenance of the improvement hereto <br /> �'.�__ _ 30" applied for and further agrees to remove same upon <br /> notice from the Ciry and to replace public property <br /> dam ed ereby. . �� : <br /> � ' ( <br /> � ignature of Ap lican � <br /> �:�.+1� /�,a.��� �4�1 <br /> COPY QF THIS APPLICATION TO Address ,�,w � � <br /> 8E POSTED ON JOBSiTE. L.�2—�4,�3 � <br /> . CALL ENGINEERING DEPT. 25&8811 Telephone Number — <br /> —t��rt � � q'z�. <br /> 24 HOURS BEFORE CONSTRUCTION Date — <br /> CHECK LIST Fee � — <br /> Waror Valve <br /> Drainage Dept. Approvals <br /> Curb& Gutrer Engineers <br /> Sidewalk <br /> - Water��/•R1�1"� ��_ , <br /> Street_ ___ ___ <br /> Inspector's Signature �.��� <br /> Commun:cations <br /> Tratfic _.�'��4' ` i 5 lo �7G <br /> . <br /> ' Planning_ <br /> ate ��1:Y9/� ���� � <br /> � _ : <br /> . <br /> Remarks � - _ _ <br /> Note: Onginal to Customer <br /> 1 Copy to File 10 4 6 7 ' <br /> 1 Co to In Approved by } <br /> PY spettor <br /> Date Approved <br /> lu, �' <br />