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APPLICATION FOR RIGHT•OF-WAY USE PERMIT <br /> everett ^ ' <br /> + � 1�V�Y <br /> CITY ENGINEERS ' <br /> EVERETr, WASHINGTON G'? I <br /> � � PERMIT N0. �C� ` l �- � . <br /> The Undersigned_� �: '�� (� ;-� __ ��� <br /> , Hereby applies for permission to i ..�� _ - � � - -� •� ' ,� ,�,. ��� --��; ' if�V` � ,� �; <br /> i <br /> � At the following location �J '-1 I g �� �� , /� -�,. i -%� � �-� ' : <br /> i SKETCH <br /> � (Work to be done) � <br /> I ^ �� i <br /> i \��� f� I <br /> ����/ \ <br /> I '� 'C) <br /> �� � � � �I <br /> � � <br /> � r� � � <br /> i t• � b�" -. � <br /> � . Y � ,\ �N i <br /> \ f � `�� ^,�- i.-. ) ' <br /> i'� � � � <br /> �. \,,. ���' -s <br /> \ � � �V ` ' <br /> � .�-�� �� ��'� '� 4 i <br /> I � � Z <br /> ; <br /> � � � , � <br /> 2918��' ; <br /> � � l <br /> ' '3� _�j �' �� <br /> � �-' �TU 8 <br /> j --= �-- >n;�- .:�_ :_na_� <br /> I —'� 4 � � <br /> { _ �� \ ---�. <br /> -- - ^�- _l-.=-==-=--.�.--:�- � � � <br /> :,��.. <br /> I L tn ..E�,,r=r�� <br /> 7. - �, , <br /> I ' . ; <br /> i � <br /> ! �RIVEWAY SECTION i The undersigned owner hereby agrees to hold and <br /> I , NO SCALE r� save harmless the City of Everett from any and a�l <br /> f�---- G��— -� j claims for damages that may arise because of installa� <br /> Ip� ��p ! tion and maintenance of the impiovement herem . <br /> ' �� � applied for and further a9rees to remove same upon <br /> � � I�-'i�-- -- -�30� notice from the Ciry and to replace public property <br /> I� damaged t �reby. �. ,� �;��. �� , <br /> � —�r�1'�, . ,::_r%�(�� �f�-�..=� <br /> �� Signature of Applicant - <br /> ' ; %.2/ :G=fTi,/'. ' '� =�.yc- i=//, [UA%. ' <br /> I COPY OF THIS APPLICATION TO i � „�i. '. Address —T . <br /> I BE POSTED ON JOBSITE. - "� ^, �.- - �„1// <br /> ICALL ENGINEERING DEPT.259�8£11 I ' � � �� Tclepno�umber �, <br /> - a_- �/� <br /> � 24 IiOURS 6EFORE CONSTRUCTIUN� Date <br /> j - � ,,- ---. . ..� , �. <br /> � CHECK LIST Fee � �- ' ' - I <br /> Wa�ar vatve � Dept. Approvals <br /> Drainage <br /> Curb&Gutter En9ineers - ' '� 'i�,� <br /> Sidewaik � - � <br /> �, Waler ti!G ,. �,i.; /���. .r.,.,/: �'��c�:'.` � ; f , . <br /> -, Sveet <br /> -�/ � '/ <br /> � /' "'��'x--� �- Communications ' <br /> � Inspecror's Signature �� Traffic � <br /> r <br /> ! Plannin9 ^7 S:iv:/-'%.- <br /> /1-�/ ��/7 S- � <br /> �te .. � � �- � <br /> , I <br /> Remarks I <br /> Note: Originai to Customer <br /> 1 Copy to File 1 n 5 5 0 — , � <br /> 1 Copy to Inspector Approved hy (� <br /> , ��`�. <br /> Datc Approved � � � <br /> t <br />