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evcren <br />e <br />CITY ENGINEERS <br />EVERETT, WASHINGTON <br />APPLICATIQN FOR RIGHT-OF-WAY USE �ERMIT <br />PERMIT N0. <br />The Undersigned _ _ f�'1 � ' � - f tl . •i i . G� - <br />Hereby applies for permission to - t ,- . . I __ � � , � viti.: - <br />_. . � J . ;t - . . i . <br />At the iollowing location_ <br />SKETCH <br />(Work to be done� <br />f p <br />i I <br />� l .�� ' I <br />N <br />� <br />¢ <br />P.�� k�n•� <br />. • � ,.. <br />'" '_`_ _ \ <br />�: <br />� <br />@ <br />ORIVEWA� SECTION <br />NO SCALE <br />�— _. — -�--�—� <br />I'� LIP <br />�...0�___ .— _._ I 30� <br />—•1' <br />iCOPY OF��iH15 APPLICATIOt� TO <br />BF POSTED ON JOBSITC-. <br />CAl1 ENGi����!EFRING DEPT. 25&8311 I <br />I <br />.4 H�JL'RS l3LFORE GONSTRUCTION <br />CHECK LIST <br />VJater 'Jalve <br />Draina�ie <br />Curb & Gut[er <br />Sidewalk <br />v <br />U) <br />a <br />�, i <br />7 <br />Thc undersigned owuer here6y agrees to hoid and <br />:ave hannless the Ciry of Everctt frum any and all <br />claims for damages that may arise because nf installa� <br />tion and main�enance of the improvement hereto <br />applied for and further agrees to remove same upon <br />notice from the City and to replace public properry <br />damaged ;hereby. <br />, <br />Signatwe of Applicant <br />Address <br />Telephone Number <br />___i' :'_,( � (,�il: • <br />Fee <br />Dept. Approvals <br />Engineers <br />Water.Ll�_ i.?.�i �' ,c, /� :::.✓< ;/ <br />�' '✓�4�C/�sx*` rpj�,((tG� �nii.�l Communicotrons <br />inspector'sSignature /` (L_�'�l�" '"" s�. i. <br />/ % ��U� �Z Traffic - %�;'� . r : �r � /, � <br />�/ %! � Plannin � �. '_ %F�_ <br />�ete <br />'� •: i :1� !l''. % �• : G.: r' S.�se ��"�7 <br />Remarks <br />Nate: Original to Customer <br />, �oPY to F��� 10525 <br />1 Copy to Inspector <br />ApProJed hy � I I <br />Datc Approved <br />