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everen <br />�J <br />CITY ENGINEERS <br />EVERETT, WASHINGTON <br />APPLICAT'JN FOR RIGHT•OF-NIAY USE PERMIT <br />w ...-rn <br />lU��L <br />PERMIT N0. � � ` � ! % <br />The Unde:signcd !Z �� h t � S--;; -- <br />Herebyappliesforperrnissiooto i„5�'r.Il 9C' �"'C�.,c c���,nf:/� .. C'f� i7/J�ni <br />-- ns ...,�:...l..,l <br />At the foilowing location <br />(Work to be done) <br />� <br />' — — 4 <br />_ _ _____. _ - – lo' I <br />��� __ LK�S���j_G,►�,__� )- ._.__I r qy��--_ <br />9 2�=° s r. n . <br />�� � �I <br />; <br />� /L <br />n �� �,- <br />�� <br />II Y _A <br />d 7_� �, <br />_� <br />i �il <br />I a �� <br />�, <br />q sa� v�; �;�: �"� <br />�n <br />DRIVEWAY SECTION <br />� SCALE <br />x -� <br />�I° LIP � <br />30'�____ I 30" <br />—T <br />COPY OF THIS APPLICATION TO <br />BE POSTGD ON JOBSITE. <br />CALL ENGIN[[RING DFPT. 259-8611 <br />24 HOURS f3EFORE CONSTRUCTIODJ <br />CHECK LIST <br />Water Valve <br />Drainage <br />Curb & Gutter <br />Sidewalk <br />Inspector's Signature <br />Remarks <br />Note: Original to Customer <br />1 Copy lo Fite 1 n 5 5 2 <br />1 Copy to Inspector <br />Plr �r..lr <br />.{!'J t����7a <br />v <br />r� %i <br />� <br />The undersign�d owner bereby agrees to hold anJ <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 improvemmt hereto <br />applied for and further agrees to remove same upon <br />notic€"from th Ci[y and to replac blic property <br />am qe by. _ � <br />� <br />- Sign u e o plic —� <br />Address <br />Telephone Number � <br />Fee �/ J 1=i= r <br />Dep�t/. Approvals <br />}% �IiL��7/ r IYe �w S� ,'� V <br />Engineers � <br />�Appr d by . <br />—i f �1 ���7�G <br />Date Approved <br />