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. . APPLICATION FOR RIGHT•OF-WAY USE PERMIT : <br /> - ��e ��. ,, -�0109 <br /> � � <br /> � , � <br /> , <br /> CITYENGINEERS , �.'- ��_� <br /> EVERETT, WASHINGTON PERiv11TN0. <br /> / J 9 ,{/ i <br /> � TheUndersigned (�1/ �Y n/�^ /,/I C/ //�� � G� �"� F'� 1 /"1 � � <br /> Hereby applies for permission to�/�K�L�r �� 07 � � O/�✓C�/�,�j�� 1��L{f <br /> 7 <br /> � At the following location 2 8 28 �� � W LV� <br /> SKETCH ` <br /> i (Work to be done) f�INAVICU�f3LVD 1\ �8 � _�-1l ; <br /> ' ..�4iE,e 9'0/6 U.vD�IP I <br /> i - .P�/�2=/,r/i¢,j' <br /> i I <br /> ; 30� , � <br /> ' �'X�sr,�r6 <br /> � NEW dBi�E'!�' C��P`�v`�C-GiT.� <br /> I 1� <br /> � <br /> �1 <br /> � NO <br /> , � SCA�F <br /> � Q <br /> I � <br /> � <br /> I <br /> ; DRIVEWAV SEC7i0N Tlie undersigned owner hereby agrees to hoid and <br /> NO SC4LE save harmless the City of Evere[[from any and all � <br /> f'— Z.�� - -� claims tor damayes that mzy arise because of installa• <br /> II �I�� LIP �� tion and maintenance of the improvement hereto <br /> I� , applied for and further agrees to remove same upon <br /> �30';,�_____��____ I 30'� � R �� t� notice from the City and to replace publ' property � <br /> —��� •#� <br /> damaged tlSer� /�i � . <br /> �I .�%'��% Ga� �'� � . <br /> �L. - <br /> � �Si§na�t,ufr/olt A{�plicant ��- � � <br /> � f ----- � ./(-/ .tJ�'�-1�e.7�c.�l� '��� ,/�/h l:1L/+ ��• <br /> I� I COPY OF THIS APPLICATION TO � Address �i <br /> I BE POSTED ON JOBSITE. �'13"� <br /> ', CNLLENG�NEERWGDEPT. 259-&871 <br /> � Telep��ne N�'r a//� <br /> - - _ _ ���� , <br /> � 2A HOURS [3[FORE COPJSTRUClION�I Date <br /> � /�i �U ��� / ��7� `�.� <br /> ' CHECK UST Fee <br /> '. Water Valve <br /> Drainage De t. Appro lals �/ <br /> Cwb &Gutter Engineers / r �S <br /> Sidewalk �' <br /> , ,r� I Water . . <br /> Street '� ��� <br /> �. ���'� ��. �i��i ., i , <br /> "�" Communicatio —��- - i �• � <br /> �, Inspector'sSignaWre ' � � " ' i <br /> , Tratfic � �� �✓ � 7:i <br /> , . / � <br /> �. `i -�:h..,..— 'S� Planning / _75 <br /> , ate <br /> � . n <br /> _� <br /> � <br /> 7 .�, i <br /> ,;1�� '��(�,���/. ./ ,�_�i�� r �fJL� . ,i; , _� ... <br /> Remarks <br /> � Note: Originai to Customer <br /> ; , �o,�� �a F��� 1010 9 <br /> � 1 Copy to Inspeclor Approv�d by � � � <br /> s <br /> . �.�-:�i o /��}/ <br /> Date Appro ed <br />