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- everee APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br /> 4�,,� -_ _. .. 10181 <br /> V <br /> CITY ENGINEERS /� �J <br /> EVERETT,WqSHINGTON PERMITNO. / � <br /> �� TheUndersigned_ �CJH�L/] / J I�d/{�j'U�/C <br /> � Hereby applies for permission ro_ ( �/3/1�Srl�(��T � ? � / /� ����rT�' ,[��GLJ <br /> / <br /> At the following location �f BL �/� <br /> SKETCH <br /> (Work to be done) <br /> NI_LJ CLING)�ETF D�P/�fl�tR7Y <br /> EJUST/N< CU,C'6 <br /> � CaU7TER. F�' S/D�l�JLK <br /> J.O� <br /> � <br /> � � w� /- Serai< . <br /> � r�je 10 �/C d 2934 � <br /> U � �1'` <br /> P,-,�,- <br /> ! U U�N� f �L <br /> � , � � <br /> I �/'�V e ��� <br /> i �� <br /> � <br /> ND SC'ALE <br /> � <br /> I � <br /> i , <br /> IORIVEWAY SEC710N The undersigned owner hereby agrees to hold and ��� <br /> I NO SCa�E save harmless the City of Everett from any and all <br /> _�I <br /> i `�,3 I claims for damages that may arise because of installa� <br /> `i" �ip tion and maintenance of the improvement hereto . ' <br /> ' 30" � yp�� applied for and further agrees to remove same upon , <br /> � �--�-�$"--- "' ��� notice from the City and to replace public properry ' <br /> damagc thureby. Fl , i <br /> � �� � . � <br /> Signat[LLJrehV�Applican ' <br /> /o�/d .�///�itG.c/F,a++� �R� <br /> �I COPY Of- THIS AFPLICATION �i0 � (�/ A l� Address _ <br /> i 6E POSTED ON J06SITE. ��A�`"' � s Z - 7 7�v <br /> � CA�L ENGWEE-RWG DEPT. 259�F,811 �� Telephone u er � <br /> � � 7_4 HOUPs i3GFORE GONSTI;UCTiON� �� Date � � <br /> ; CHECK LIST Fee O 7�' <br /> Water Vaive / <br /> i Drainage ept. pprovals <br /> � Curb&Gutter Engineers �GLt.�-G � <br /> � Sidewalk f / <br /> .. , <br /> Water � <br /> ) <br /> I •�,� -/-�/�' ;� [��'7 S«eet l9 �rM 6� �✓� A-.'�S=TS' <br /> " ��- / � — Communications . % .� �'__. _ r <br /> Inspector's Signature <br /> Treffic �•�%r� - / S <br /> � ��-� i; - � , Planning � � <br /> � �a[e <br /> i <br /> I Remarks <br /> � Note: Oi iginal to Customer e <br /> � 1 Copy to File 1��_O 1 <br /> 1 Copy to Inspector � Approved b <br /> � =��;% x.�ic.:. 5-/-7.i <br /> Date A�i�Sroved ' <br />