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eyerett <br /> APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br /> � ��96� a <br /> ' CITY ENGINEERS � <br /> � EVEREIT,WASHINGTON PERMITNO. � � 7i�3 I <br /> i , <br /> TheUndersigned_1//� SFriF���iH <br /> Herebyappliesforpertnissionto �'o���fd✓Gj A 2 / � r/)i�ic�l=7s �/ � k'.' ��L 1r - ��J' �,t <br /> �(7 c r S�JC v.,.ati/� iJ r_• "� :s:-Y,L..°r7oC 0 � .. <br /> At the following Iceation � j� 2 ��:':-1 N0 /}✓E <br /> SKETCH <br /> (Work to be done) <br /> . cr�� r-1 I Tr)� HL�� <br /> i <br /> I <br /> I <br /> ; i <br /> �i <br /> , ' {, � i <br /> j f I <br /> � �� I <br /> • ` I <br /> � <br /> � <br /> h' , <br /> Y1 <br /> �' I <br /> � <br /> � <br /> � <br /> I � <br /> , DRIVEWAv SECTiON The undersigned owner hereby agrees to hoid and ' <br /> i NO SCALE save harmless the City ot Evcrett from any and all <br /> � f'—--- --- --� claims for damages that may arise because of installa� ��, <br /> I f' LIP tion and intenance of the improvement herem � <br /> �� applied r and fwt r agrees to remove same upon <br /> . �-30�--- ----�30—� noCce ro he Cit4 d to re lace public property �I <br /> dam ed th eby � <br /> t ! <br /> -. S�g � t�P�V1V t7� bs ���2� <br /> � COPY UF THIS APPLICATION TO � Addres i� <br /> . BE POSTED ON JOBSITE. �-1��I �U 1T E �114L� ��-,�1— � <br /> CALL ENGINEERING DEPT. 259�8811 Telephor�e rroer , <br /> � to � ^- � � l�� i <br /> 24 110URS BEFORE CON57RUCTIUN Date p� � � �� � I, <br /> ' �� <br /> CHECK LIST Fee � <br /> Water Valve � ' <br /> Drainage Dept. Appr<� I <br /> Curb &Gutte� Engineers �Z� � <br /> Sidewalk Water_ I' <br /> Street <br /> Communications <br /> Inspector's Signatwe ' <br /> Traftic <br /> Planning_ <br /> at-6 e <br /> �I Remarks — <br /> � Note: Oiiginal to Cusromer q . <br /> t Conv to File 10 C�6�r <br /> 1 Copy to Inspector Approved by <br /> � Date Approved <br />