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everetl <br />� <br />CITY ENGINEGRS <br />EVERETT, WAS:�INGTON <br />The Undersigned <br />Hereby applies fo <br />APPLICATION FOR RIGHT-OF-WAY USt PERMIT <br />10237 <br />—' , � , � <br />PERMIT N0. � -j — % �—' <br />At the following location � � � .=�/�/v� �O ' � �� <br />SKETCH � �� r ` � <br />(Work to be done� / � . i <br />; <br />t <br />i, <br />r'D <br />n:. <br />5 <br />� <br />NtZ'UI ��7`�PN <br />d10 SCAL � <br />DRIVEWAY SECTION <br />NO SCALE <br />� � � � <br />}I�� LIP � <br />4..3�..�,.— _—�� � _ _--•}•30"..I <br />COPI' OF THIS F�P?LICATION TO � I <br />BE POSTED ON J08SITE. i <br />Cl�LL FPJGINGERING DEPT.259-II81 i � <br />�'_'�1 IIOUitS CE1=UfiL CONSTRUCTIONI <br />CHECK LIST <br />Water Valve i <br />Drainage � <br />Curb & Gutter � <br />Sidewalk � <br />Inspector's Signature <br />at-1S e — <br />Remarks <br />Notc: Original to Customcr <br />1 Copy to File � 02'� 7 <br />1 Copy to Inspecmr <br />L'/fAl <br />� <br />✓ <br />_ � <br />I <br />i <br />i <br />�� l.i%.: %( <br />U'ill,(. Li'1 I. ii-1 <br />7- ll- 75 <br />c�.�.: s <br />t�,�sz�arnir <br />Z6 <br />M�u�ti�uM i��� c��v���r <br />-�5� <br />— /6� <br />�'()G'£ OF t�XISTING <br />r��v���►✓r <br />� <br />��The undersiyned owner hereby agrees to hoid and <br />save harmless the City of Everett from any and all <br />claims for damages tliat may arise because of installa� <br />tion and maintenance of the improvement hcreto <br />applied for and further agrees to remove same upon <br />notice from the Ciry and m replace public properry <br />d�aged tl�eby�/ � � <br />Q-L�/ �.G ( A�J <br />Si naWre of Applicant � <br />�� Bou '�a � /Y1Ll,YiL��.� I�a ��-` <br />Address --� <br />.�'SS- //�'c <br />ielephone Numbcr <br />�a,�. <br />�L . ��O ' � I � � '7�� �I <br />Fee <br />� <br />S <br />APPr v d��%��/� �(�� r <br />"�'-N,i^ �-i//!i!'i✓�vC.v 8— � 7J �. <br />Daie Appr ved <br />