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everett <br />e <br />CITY ENGINEERS <br />EVERETT,WASHINGTON <br />APPLICATION FOR RIGHT•OF•WAY !JSE PERMIT <br />The Undersigned L� � r�� U. /�c* fc^� � o ri <br />Herebyappliestorpermissionto concfrc,ci- a 2S'�_�h v�w <br />At the following location _ 9 7 I P L,� n n e w oo d D �. <br />— � <br />�Work to be done) <br />10460 ��, <br />��� <br />PERMIT N0. � � � ��-� � <br />h� <br />� <br />_ _. _ — - — — -q� <br />- - - - - - - - - - - - - - �`.3� �`, <br />- r <br />:+ing / i <br />C u�vCr%� <br />�� <br />� i <br />'"-�� 1 4� <br />I S \ <br />r <br />`�� �] ll,.J i� <br />�.! ` r: P <br />^c��h\ •.. R�� 1 . <br />l! <br />Note : No side Sewer ayniln6/e, <br />Foe TH/s .Cor <br />/�IO Jcr.�F <br />� �--(� i�.. G,�„ <br />.-. q'i(- <br />DRIVEWAY SECTION <br />NO SCALE <br />V 2 S ' --- ---I <br />I" UP <br />�30y__ _ I 30•� <br />-i- --'1' <br />COPY OF THIS APPLICAT�ON TO <br />BE I'OSTF.D ON J08SITE. <br />CALL ENGINEERING DEPT. 259-8811 <br />_24 HOUR; C�EI-ORE „ONSTfiUCTION <br />CHECK LIST <br />Water Valve <br />Orainage <br />Curb & Gutter <br />Sidr.walk <br />Inspector's Signature <br />ate <br />Notc: Original to Customer <br />1 Copy to File <br />1 coPv to �nspecmr <br />4,I v�[) <br />En� <br />12" <br />��4 <br />e'� <br />i <br />11 ' \ <br />w. ' , a i(, r�.� . <br />''s.� fC�� <br />,•,..,.f°/.� ��1� . <br />�• L yk� <br />:r.c� �. <br />�I7a6 �� <br />� <br />� ' cx���in� <br />Inle1 <br />The undersigned o�vner hereby a9rees to hold and <br />save harmless the City of Everett from any and all <br />claims tor damages that may arise because of installm <br />tion and maintenance ot the improvement hcrem <br />applied for and turther agrees to remove same upon <br />notice trom the City and to replace public property <br />dam�geU U��ereby; � � <br />i <br />/'�/%','.N �� �/.<.i>7�n <br />Signature 6f A p,icant -- <br />l,v.�, ,:- ,,,.1 '` �r <br />Address ' <br />;J ) `,� � � iY <br />TeleUhone Nur�ber � � <br />� / � : i �j ; �: <br />Dair' � n <br />Fee � 2 , r'i /�� �A/c�Tl_ <br />ep pp val <br />Engi � <br />Wale�a-��.� /1'�PFSeIiP b'G.,d <br />Street � / �7 <br />Communicatioas r � ./" ` r'7.n-� -_. <br />i <br />Trafiic " - � � - - r,e%� <br />/ <br />Planning � � <br />Ser�c-�: NC'.�iu, as,,., C`�id,G+d <br />�^ <br />.Ll"fnQ <br />Approved by � <br />, ,�c �86 <br />Dat Ape proved� � <br />