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AP'�'LICATIOW FOR RIGFIT�OF-WAY USE PERMIT <br /> evcretl . ��0�^ <br /> .. � L <br /> CITY ENGINEERS '7/� '� <br /> EVERETT, WASHINGTON PERMITNO. /`'7" �GO� <br /> I� The Undersigned � � � O/U/�-/ � �� . <br /> � Hereby applies for pertnission to_ �.C']�)S l l L� z — � C G�C"1 C <br /> � At the followinq location Z ��L S �,A (1 /LG-�'��.LJLI�,� <br /> SKETCH <br /> �I (Work to be done) <br /> NO sCNL.E <br /> 116 I l � I�0 <br /> I <br /> rJ <br /> ZazS <br /> , SIv�WA[K NE� CdNCR�TE <br /> w <br /> i� c��,�,� � �vric�; � <br /> i �w E�6E oF t.f'/STiAi( <br /> � � ,�,9!/E�vIEiVT <br /> I <br /> I _ �— <br /> � PANHVIEhI BLYD. <br /> . <br /> I � <br /> � <br /> , <br /> ; <br /> ; DRIVEWAY SECTION The undersigned owner hereby agrees ro hold and , <br /> � NO SC4LE save harmless the Ciry of Everett from any and ail <br /> �— 2,�� --� claims tor damages that may arise because of installa� <br /> � i" ��P tion and maintenance of the improvement hereto � <br /> :� applied for and further agrees to remove same upon <br /> I 30�� ----�---�0�-�.30.� �1��'� " ` notice from the Ciry and to replace pubiic properry <br /> i dama there . ', <br /> I , i ' <br /> i !Signature f Applicant ; <br /> ; PD ���r 27C7 L-'�fct�Tl�/i�r,�� i <br /> COPY Of- TtiIS APPLICATION TO G ✓ n i Address <br /> 'I BE POSTED ON JOBSIT[. � ��'� � �5� �G S U O . <br /> ' Teiephone Number I <br /> ' CALL ENGW[ERING DEPT.259�8811 l'L� ^ , I nP� 3� lT7� - -' I <br /> I 24 HOURS BPFORE �;ONSTRUCTION ��v Date _ ' <br /> , 1 � Z �� �,_ �� '�. <br /> � CHECK LIST ' Fee / <br /> Wacer Valve Dept. Approvals �' ( ` <br /> �� Drainage ' '� <br /> ' Curb&Gutter Enginecrs Z-{I -7y' <br /> �� Sidewalk Water � . ✓��x - ' <br /> ' Street � � � <br /> e, �1�"t( Communications '� <br /> . I�sp ctor'sSignawre Traffic � �.� /a/7 � '. <br /> � _� y_ �� Plannina y • . �� � _<'dr�/ /Z-5` %yC <br /> -�.' // <br /> , �U /�����-/UO �h' <br /> Remar� � I <br /> � Nr _ Original to Customer <br /> �� 1 Copy ro File '1 ��C�? 4 � <br /> �. 1 Capy to Inspector Approved by � � � <br /> CG• �/' , <br /> Date Appro <br /> �G,. /� �¢ <br />