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W <br />CITY ENGINEERS <br />EVERETT,WASHINGTON <br />APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />PERMIT NO. <br />The Undersigned ITA,t/ do (Fri,: Al'oia.? Tririccc <br />Hereby applies for permission to rGrrlau,, aj, rp j i r,C r In • n r- 5�, P RF_ A/.> -er rT ur r rej An1��7� ■ <br />At the following location C/ Z O eA'14-nr t2ya'- ` APF, <br />(Work to be done) <br />"Ot*; <br />h� ra7 r5� <br />1., the re•*tova I o ( L �p+rmaf�- <br />- n' <br />5,,4✓trrA/k a? 1g2d Gr AnJ /�✓°• (h� Cu. 6, CuttP <br />7.+J sIJev.,r/A w,11 a/so r ewJ rPP/ac��t9 as pr• <br />0 <br />DRIVEWAY SECTION <br />NO SCALE <br />\\ �� +P LIP .. <br />_i_30"_I <br />COPY OF THIS APPLICATION TO <br />BE POSTED ON JOBSITE. <br />CALL ENGINEERING DEPT. 256-9811 <br />24 HOURS BEFORE CONSTRUCTION <br />CHECK LIST <br />Water Valve <br />Drainage <br />I Curb &Gutter <br />Sidewalk <br />Inspector's Signature <br />j sY y <br />t <br />Remarks <br />Note: Original to Customer <br />1 Copy to File - .1 0 8 6 4 <br />1 Copy to Inspector <br />f . <br />4: <br />The undersigned owner hereby agrees to hold and <br />save harmless the City of Everett from any and all <br />claims for damages that may arise because of installa- <br />tion and maintenance of the improvement hereto <br />applied for and further agrees to remove same upon <br />notice from the City and to replace public property <br />damaged thereby. %`.-j,'fi,,yi <br />/A/// r) R/! L <br />Signature of Applicant <br />f iDae r cdFps rT <br />Address <br />:� :g --?5-/9/ <br />Telephone Number <br />f -.22 --J 7 <br />i 1 <br />Date <br />De./pt. Approvals <br />p <br />Engineers !e Z r� <br />Communications <br />Approved by <br />Date Approved <br />