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_.. . . � ._ . .,. "'.r . . <br /> , '. <br /> " cvemn APP�ICATION FJR kIGHT-OF-WAY USE PERMIT <br /> � 11o9s <br /> CITY ENGINEERS <br /> EVERETT,IYASHINGTON ' �' <br /> PERMITNO, ` � �`t� <br /> Thc Undersigned �fJE i . n�..�F <br /> Hcreby applics for permission to /.'_nNrTiPur-" i�3 2�S � � <br /> /�nn�i^•�r._1£_ j�/„� <br /> --�7�-- <br /> At the totlowing locat'on 1`I'� 7 %ffq�a v�G�� s� �, <br /> SKETCH <br /> (Work to be done) . <br /> S c E i-�rrq c cf�� <br /> c.,' - -_"�y. <br /> , A <br /> . �� <br /> ��"rS <br /> ' �//�� <br /> / � <br /> OFtIVEWAY SECTION • <br /> NO SCALE The undersigned owner hereby agrees to hold and <br /> __ _ _ � save harmless the Ciry of Everett from any and all <br /> R` claims for dama9es that may arise because of installa• <br /> L�_.___V_� ��P � tion and maintenanca of the improvement hereto <br /> j,�]0'� ( .�_ _ ��p^� epplicd tor and turther agrees to removo same upon <br /> notice from the City and to rnpla public property <br /> da d t rebyl ��j� � <br /> ' . :�`—GE:.._. <br /> _ Sipnature�Appli p � � <br /> COPV OF THIS APPLICATION TO Ad ress� � '� <br /> BE POSTED ON JOBSITE, 3�q... �,�,� / <br /> CALL ENGINEERING DEPT. 259�6811 Telephone Number <br /> 24 HOURS BEFORE CONSTRUCTION Date — <br /> CHECK LIST Fee ��.' .� <br /> �Yater Vaive . �. . <br /> Drainage Dept. Approvals <br /> Curb&Gutter ' <br /> Sidewalk ' Engineers <br /> Water <br /> Street <br /> Inspecror s Signatura � Communications _ <br /> Traftic <br /> Planning <br /> `bate <br /> Remarks <br /> Note: Original to Customer <br /> 1Copytofile 11096 <br /> 1 Copy to Inspecior Approved by <br /> Date Approved <br />