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reveretl <br /> � ��` APPLIC/1TION FOR RIGHT-OFWAY USE I'ERh11T <br /> � 10001 <br /> � CITY ENGINEERS PERMIT NO. / ' ! � I/ � <br /> EVERETT,WASHINGTON <br /> ' The Undersigned U (> �j C�N�iTG2 CO � �� <br /> Hereby applies for pertnission to !'.��ISTR /.� � S� W \ I� 1�1C DR �\�E\n_ /,4�I_ <br /> � At the following Ixation 2 9 r j�A 1�1/��l t E W ���['j. � <br /> ; SKETCH <br /> i (Work to be done) I � <br /> I I <br /> ' No ScA�E <br /> � <br /> ' �oT 127 , � <br /> , , <br /> � <br /> � ' <br /> � <br /> � <br /> � <br /> , <br /> i <br /> 29zS � <br /> i <br /> 1 ,� �..�T <br /> i �5�.��� <br /> � <br /> � ,aOs Yo �o ,yy_�y <br /> I <br /> 30� <br /> � <br /> PANAY iE,w F�LVD_ g' —� <br /> �� --- i <br /> DRIVEWAv SEC710N 60� �The undersigned owner hereby agrees to hold and <br /> NO SCALE save harmless the City of Everett from any and all <br /> f'--- 25�— -� claims for damages that may arise because of installa� <br /> � �p� ��p �� tion and maintenance of the improvement hereto <br /> � applied for and further agrees to remove same upon <br /> �; 30'+__ ____ I 30" notice from thc Ci ty an t ep e pub�ic property � <br /> --•1• <br /> dam a ln-. <br /> � � !G �!%�^"� . <br /> � Signature of Applicant �� <br /> ') � i,z s;Q ,�2ora Pw�t y <br /> ', COPY OF THIS APPLIC�TION TO � 4J�;j Address � <br /> ' BE POSTED ON JOBSITE. j _ C l��-/CETT /,(Jn( � <br /> i ' Telephone Number � <br /> ; CALLENGWEERINGDEPT. 259-8611 �i � S:3 —//ZZ. I <br /> ' 24 HOURS BEPORE CONSTRUCTIOP!; Date S�i n . <br /> CHECKLIST Fe r� 6- 1� � 7y . <br /> ' Water Valve � �. �� � � 34�C�U <br /> Drainage t �- �� r Dept. Approvals <br /> � Curb&Guuer � � E ginee�-'y�}—1��� + � ��- . 5=79 ' <br /> � Sidewalk � o /�1 <br /> Water_�_� <br /> J-y' <br /> ' Stree[ -��� �7 r�^-� <br /> /� �� p' i <br /> � �c�.n��� ��Ul.� C.1/{� �Q �7- 7/ Communications;� <br /> � Inspector'sSignamre � � ,?;i � <br /> ,� � �JJU'D� Traffic ����'J-'./}�� �.AiF� . -,/4 <br /> � Planni�9���ii [. �-��' J�� I <br /> (n ' �� " ��� <br /> ! ate <br /> , _ ` <br /> i <br /> Remarks <br /> �. Note: Original to Customer , <br /> � conv �a F�i� 7 0001 <br /> i Copy to Inspector Approved by <br /> � ��'�' � -``=- <br /> Datc Approved <br />