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everen <br />� <br />CITV ENGINEERS <br />EVERETT,WASHINGTON <br />The Undersigned �` " �� <br />Heraby applies for permission to <br />At the follr��ing <br />� (Work to be don <br />� <br />. I� j I <br />�y)\ <br />i�' <br />APPLICi,T�ON FOR RIGHT-OF•WAY USE PERMIT <br />10345�� <br />�f ��j�j� <br />PERMIT N0. � � � - <br />�, %�, � <br />� >�CL_ �• ��J C J� '� i C' Vf /�� <br />e'�'• <br />�"�� � =' •'7� �--- <br />Ib <br />i1 <br />Ig <br />3 <br />G,F-!,'v0 � �� <br />�Ex;sri�vG -- <br />/i�� .`�! 1�T GCJ't'�i <br />�.�' _ <br />-; .s <br />DRIVEWAY SECTION .� <br />NO SCALE 25 <br />f•-- •�rt - _ --i <br />+I'� LIP � <br />3�"�---� _—•f 3O"•1 <br />ZU' <br />COPY OF THIS APPLICATION TO I <br />BE POSTED ON JOBSITE. , <br />CALL ENGINEERING uEPT, 259-RB11 i <br />24 HOURS E3EFORE CONSTRUCTIONI <br />CHECK LIST <br />Water Valve <br />Drainage <br />Curb & Gutter <br />Sidewalk <br />� <br />. � �A <br />< � tur s Sign re <br />"� ��-1� <br />ate <br />Remarks <br />Note: Original to Customer <br />t conv to F�ie �. 0 3 4 5 <br />1 Copy to Inspector <br />N <br />��>> -, <br />8 �-�� �i �'E� % <br />/� <br />I <br />The undersigned owner hereby agrees to hold and - <br />save harmlr.ss the City of Everett from any and all <br />claims for damages that may arise because ot installa� ' <br />tion and maintenance of the improvement hereto � <br />apptied for and further agrees to remove same npon '. <br />notice from the City and to repiace public property <br />damaged f eby. � � <br />Sign " re of Applican � <br />„ 3 <br />Address <br />�t'y-�aac <br />Telephone Number <br />�2-.�2— ��—� <br />Date <br />Fee � � 2 • S �./, � 7�y/j�' <br />/'/'I���� <br />%�i/ 1l� <br />... . •..� .�. � <br />, � _������ � <br />�. • .� . •. <br />