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- APPLICATION FOR RIGHT•OF-WAY USE PERMIT ' <br /> � <br /> � -�e so�6� � <br /> I CITY ENGINEERS � <br /> �i EVERETT,WASHINGTON PERMITNO.�/-. — `"? , <br /> I The Undersigned S Q tl�� r r+ rl � '�i f• l� _ j <br /> i � 'Q�'--�,�._ <br /> � Hereby applies for permission to r e i.+I c c F 5� � t ,g„ o � c'o n c i-t� tr S�w _ I <br /> 'i �niir)rn � rn �/<. rr exiS�';.,, �/�� c. � �on i <br /> i ' ' <br /> At the following location 1'i ? Z C �n .�, rl A vn � <br /> II SKETCH ' I <br /> I, IWork to be done) � <br /> i <br /> � <br /> , � <br /> i <br /> i <br /> �i � <br /> . , 9 0 ,—��---- �� I <br /> � , <br /> � � <br /> � i � � w f , <br /> , � � > ;;i <br /> � �- � <br /> I - _ ' � ' <br /> W..,F� I' ; <br /> , � <br /> i � s z._ a 1� , <br /> I �' , <br /> 2 �� <br /> -/l,.8' r.' 7' i Q ; <br /> �I I 2 � I� I � � I � <br /> � � s.�..,�. '' o • ° �j ! <br /> � ' ��. � a ' H i . <br /> IN D. ' `--� i <br /> ! _ __'_-_ -- , < . 4 . .1 � ,I I <br /> �I � <br /> ! ;I <br /> � ,Z" <br /> i_ Mo ::�.. �P <br /> 1-a-- c'�9' <br /> � . �f��l j� � I, I <br /> S��c/7G �� I. � �I I <br /> � I I <br /> �. <br /> i I <br /> , � <br /> [�t7IVEwAY SEC7ION The undersigned owner hereby agrees to hold and I <br /> ; NO SC.4�E save harmless the City of Everett from any and all I <br /> i /S' -- --� claims for damages that may arise because of installa- <br /> I —�„ `�_ --� tion anA maintenance of the improvement hereto I <br /> . �—J � applied for and further agrees to remove same upon <br /> ; 30" I __ _�.___�30"� � notice trom the City and to replace public properry I; <br /> � dam ed thereby. / � i <br /> � i9natur o Applican ( , . � "���i 1�� <br /> � CO?Y OF T!il; i1PPL�CATIOh l'J � dress �, i <br /> ' IEEPJSTEDONJOftSIfE. � z-'� 2 ^ 44�3 I <br /> Telephone Number �-� I <br /> CA!1 ENG�N�ERIN3 DEPT. 7.59-8R11 � r,AY t. � �—f�, <br /> i I <br /> � �4 ilOUHS 13.-PORE COUS��RVCTIGNi Date � , <br /> I._ •`` D ��c �� 7 , �`f1 -- <br /> CHECK LIST Fee , <br /> � Wacer va�w Dept. Approvals "-� <br /> Dre�nage Z � <br /> � Curb &Gutrer Engincers _ <br /> � Sidewalk _ Water U.o.,,����ti�2G17( � <br /> � /,'� Street ' � �;� � _ _ '' <br /> c!/ Communications <br /> Inspector's Signature �� . <br /> Traffic ' ro � <br /> i <br /> // � � o � 7 6 Planning • � � �7� <br /> atc „��-Y 'A/,C �-f. � wTSe ,.r �/ d�3�'f'7C� . <br /> Remarks <br /> Note: Original to Customer � <br /> , ��P� �� F��� 10467 <br /> 1 Copy to Inspector Approved by , <br /> c--',F:' u ,���.s �_ �� L�;� <br /> Date Approve��— � <br />