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� <br /> APPLICATION FOR RIGHT•OF•WAY USE PERMIT : <br /> , everetl � ' 1 O 1 O 8 il <br /> � � 1 <br /> CITY ENGINEERS �/ . <br /> EVERETT,WASHINGTON PFRMITNO. 7S- 'T <br /> � �/ �.' � <br /> � The Undersigned i .�� i� /�y/ C� � �� i7 ) ��7 G E7/ 7 /�� <br /> � Hereby applies for pertnission [o CON�T'�(/eT o�� � (��/���T� 1���/ , <br /> . At the foliowin9 Iceation 27�� /�i7A/f� ✓�Fi✓ i�Lt// . �. <br /> SKETCH — � <br /> I (Work to be doi�e) � <br /> I ' . <br /> I I <br /> i I <br /> I <br /> I ��il/fa b�/E V✓ ; <br /> � ���,,� <br /> � `- I'' � <br /> 1 � <br /> I -� � � <br /> Zt>' � <br /> I , <br /> iI <br /> I <br /> � 27 30 <br /> �7 <br /> 98 a-9 <br /> I � <br /> � DRIVEwAv SECTION The undersi�ned owner hereby agrees to hold and <br /> INO SCaLE save harmless the City of Everett (rom any and all � <br /> �—e"2�� —"� claims for damages that may arise because of installa� , <br /> +I'� LIP tion and maintenance of the improvement hereto ' . <br /> I , 4� '� �� appiied for and turther agrees to remove same up n ��. <br /> 30'.,,�—,-� � -�3o ` notice fr �he City and}�replace public��ropeFy <br /> a-D--- damag erR � � /� <br /> � �-� :/l� ( o / �� � <br /> � i 9ature qf Applicant <br /> � � � � � �.y�Q���! <br /> ' COPV OF THIS 11PPLICATION TO -�1 Address � . <br /> � �E POSTED ON JODSITE. �'��_ / � Telephone Nu ber <br /> � CALL ENGIMEERING DEPT. 2'_9�8811 i (�e,�}7. �� �� Q� �, <br /> W U J' <br /> 24 Fi�URS BFFORE CONSTRUCTIOhJ �., `/�{(9 Date ' <br /> �[a, so � � � -a���� <br /> CHECK LIST Fee <br /> �Nater Valve De t. Apprqqals <br /> Dreinage j�j <br /> Curb&Gutter Enginee � � �"�'"� / ,�` � <br /> �, Sidewalk Water � � ' , � �-q�0.jS <br /> , � ; , , � „ : , / <br /> i-I // Strcet "/ <br /> C=�` // l��-`-/, <br /> Communicalion <br /> , Inspector'{S�gnature " 7 ' � - �- �. <br /> Traffic � / � <br /> d <br /> � � - - Planning- ' '7� �� <br /> � L.. � � � � i �- <br /> ate <br /> Remarks � <br /> Note: Original to Customcr <br /> 7 CopY to File � r, 1, � R � � �- <br /> 1 Copy to Inspector Approve � --r+��- � -'�i <br /> � -=d's�:T ..i'/i „- ���/ <br /> Date Approved� ' � <br />