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_�-� <br />e�emn <br />� <br />CITY ENGWLENS <br />EV[RETT, 1'�.4SHINGTON <br />Thr. Undcrsiyned ,��(_._ <br />11PI"_ICATIO�v FOR RIGHT-UFWAY USf_ P[R'+7�T <br />�� <br />1104�' <br />, , -• <br />PEf1tJ:T N0. '' � � <br />h , <br />Harebvappt�esforpennissionto.,L,J}�%'-.>d:!!" •' ' ""� '� ••,,.: --,��" ;)%��� ^ <br />__...<_._i_�_.`.. '..iu�_�_�- ---- -- <br />% <br />Atthefollowiuqla:atimi_i:.,�a�r� -_�:<��_,�-�,.,L,�-_-.-_-. -.--_'- - �- -------- <br />(Work to bc done) <br />vif�� ;f.�,` `.. •i:::'�'.% <br />�� f'O ��h,f//v�—� <br />i v / /A 3� 7J <br />ORrvEWAV SECTION <br />NO SCALE <br />�-__.. . _ _._ _.,._. . .� <br />�__..�'_ LIP � _-_...: _—J <br />��Q.� 4----� _ �30'-1 <br />COPY OF THI.i APPLICATION TO <br />BE POSTED ON JOESITE. <br />CALL ENGWEERING DEPT.269.Bfl11 <br />24 HOURS DEFORE CONSTRUCTION <br />CHECK LIST <br />Water Valve <br />Drainage � <br />Curb & Guver ' <br />Sidewalk <br />Inipa;tor't Signature <br />Rem�rks <br />Nofi: Oripinel to Customer <br />1 Copy to File 11047 <br />1 Copy to Inspecror <br />Thc umh�rsigned owner heroby a{�roct to hold nnd <br />savc haimless the Ciry oi Evcrett from nny and all <br />claims for damage; thae may arise 6ecnuse of inxi.�lle� <br />tinn and maintenonce of Ihe improvemrtnt heteto <br />npplicd for ond hu ther agrees to removr t�mr. upon <br />notlr.c from the City and to replaco public property <br />dam/[:yiy'pd � atr.hy. <br />1 �....l.I.-} .�_l.'� y���� -._. <br />Sl�natwc ol A ptivant - <br />a�/6^_ 1� .., �`.' jr. �� <br />Addreas - <br />..�."):_%%%i <br />Telr�,�;ione Numbcr - <br />_..� r_:_:..�� ,-' _�� ------ <br />Oale '- <br />Fcc - � ti .. -- - <br />Dept. Approvals <br />i! <br />Enpinecrs_� �t� . � �. . <br />Strcct_____ _ � <br />Communicetions <br />Plann <br />Approved by <br />Date Aooroveci <br />- J <br />