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APPLICATION FOR RIGHT-nF-WAY USE PERMit <br /> everett W 1,Q rj�� <br /> � � <br /> �. CITYENGINEERS PERMITNO. �E' '� ' 9d <br /> EVERETT,WASHINGTON �� <br /> �'i The Undersigned D C o � <br /> Hereb applies for permission to o t F o 2 S � � r �� i � R — <br /> Y <br /> G � — — --— <br /> At the following location 2 � � n �° ^ ` � � � � -- <br /> I <br /> SKETCH <br /> II (Work to be done) <br /> . ` <br /> �� / N-c�M1 r�C - <br /> � � <br /> /W <br /> � A � <br /> �\r �` 7s � V <br /> �,, a y <br /> �l� - -., ���r � <br /> �Q � <br /> `F,. '� � <br /> . � �� <br /> � � � � � � <br /> `'' � <br /> ,'. ' �/ y <br /> a n / Q � <br /> \ . 4 <br /> � � <br /> V <br /> N <br /> `�s ii� 'C '�. <br /> I L � <br /> I r/L /'/`\ <br /> �1� <br /> i <br /> I � <br /> i <br /> i y (�L <br /> � ��OIQ ' � `/`�QfPf SnrViC2 . <br /> f�p thi5 lot, 7d be <br /> �= � el �l locqt�d . <br /> pra ....n b� <br /> �� b�zf./�c �. <br /> DRIVEWAY SECTION The undersi9ned owner hereby agrees to hold and <br /> NO ScaLE save harmless the City of Everett from any and ail <br /> i , � 2�r� _—.: claims tor damages that may arise because oi installs� <br /> I <br /> I tion and maintenance of the improvement hereto <br /> I" LIP applied tor and turther agrees to remove same�pon <br /> I ' � 3 ___ I 30"� notice from the Ciry and to replace pubiic property <br /> �`�� � ~�� dama5ed t�ereby. C• �///� <br /> I avs l ' <br /> �, � ' Signaturc o �� a <br /> �, z 9i� �A•�/AlJiEs!] �i.�, <br /> —;--------— -' Address <br /> COPY OF THIS APPLICATION TO yStiS —34 1 <br /> I BE POSTED ON JOBSITE. � Telephone Number <br /> ' � CALL ENGINE[RING DE?T. 259�E611 Slz �.� ��/ <br /> I 2�1 IiOURS BEFORE CONSTRUCTION Date . <br /> - ---- � iz . Sd <br /> � .— .. _._--- . .. Fee�..� �2 �%� J G., � <br /> CHECK LIST � " � ' <br /> Water Valve De t. ppr 15 <br /> yy� ' <br /> � Draina9e Engineei. �n+1 �A � CCiIQ (LldliL�ry�3cI7C, . <br /> Curb&Gutter ' <br /> � Sidewalk Water_ <br /> Street_ <br /> � Communicat�ions �� <br /> �i Inspector'sSignature Traffic T�..�.�� I�-°^- e'����� <br /> Planning <br /> atc <br /> ' Remarks <br /> � Note: OriginaltoCustomer 10565 ) <br /> � 1 Copy to File App <br /> �� 1 Copy to Inspector 7 PV���,y/� � 9��[. <br /> Date Approved <br />