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APPLICATION FOR RIGHT•OF-WAY USE PERMIT <br /> eveiett 110 5 i <br /> e � <br /> , <br /> CITY ENGIN'eERS �, i <br /> EVERETT,WASHINGTON PERMIT N0. �' ���' <br /> � " Iir � /�1- �i � S � �. <br /> �� The Undersigned_!�1 � r a�l� Z �;,� " ��, <br /> �i Hereby applies for permission to %� ✓<f P✓r� r� 3 i � �,�F'N �i"L � ', <br /> At the following location���_ � � -- I <br /> SKETCH � <br /> (Work to be done) ', <br /> �� �,Ci� l=� l / R��'rYf�r� i <br /> i <br /> I <br /> i <br /> I <br /> I <br /> I <br /> I I <br /> I <br /> I <br /> I <br /> i i <br /> I <br /> i i <br /> I pRIVEWAV SEC710N The undersigned owner hereby agrees to hoid and i <br /> � NO SCALE . s�ve harmless tl�.e City of Everr.tt from any and a�l I <br /> claims for damages that may arise because of inst�Ila� �� <br /> ��I � � tion and maintenance of the improvement here .. � � <br /> �I" LIP --� . app�ied for and further a9rees ro remove same o,�on �li <br /> ' 30' � __,_--�30'� notice from the Ciry and to replace public properry <br /> 'il �-- ��--�---- dam er y. — '� . <br /> I ---. .. _ . . _. .... _ — i natureof PPlicant <br /> ddress 7 <br /> COPY OF TFIIS ���'�'LICATION TO II ��1_C 5-0�' I <br /> �� I BE POSTED ON JOOSITE. Telephone Number •�i <br /> � CAI_L ENGINEERING DEPT. 259-AB17 �I /6 —� s-77 � <br /> � 24 HOURS CiEFORF COfdSIFUCTIOiJ� <br /> Date � <br /> I CHECKIIST Fee /,� � <br /> 'I Water Valve . � Dept. pproYals <br /> Drainage �� <br /> I Curb&Gutter _ Engineers ri -���k -� <br /> ' Sidewalk Water <br /> i . <br /> I " Street <br /> i Communications <br /> I'� Inspector's Signawre Traftic � <br /> Planning_ � <br /> —batc <br /> � <br /> ' Remarks <br /> INote: Original to Customer <br /> �'� 1 Copy [o File �.1051 Approved by <br /> 1 Copy to Inspector <br /> � Date Approved <br />