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APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br /> " everclt �O��� <br /> e �; . <br /> CITY ENGINEERS <br /> EVERETT,WASHINGTON PERMIT N0. � � a , <br /> TheUndersigned (�i-l�!_ i= L.�.iJ ,i'���Vr:;% i� , (�i,.:� ;�r �_ .��� 4!>>i�1 i.�J � <br /> � `',�c � <br /> Hereby applies for permission to �n N�1< v LT �d rl `T x-�e/U';?i'�;i� �� ��/ <br /> At the following Iceation � '�' /0 P/q C� . '�. <br /> SKETCH I <br /> � (Work to be done) �� <br /> s l�/� !�� / %f-�(� /T%� � . <br /> . - � <br /> � <br /> I <br /> i <br /> .. -.",.,,,��\�, I <br /> i <br /> I <br /> i <br /> I <br /> ' - <br /> II <br /> , i <br /> I <br /> i <br /> i <br /> I <br /> � <br /> I�i <br /> � ORIVEWAv SECTION The undersigned owner hereby agrees to hold and <br /> NO SCALE save harmless Ihe City of Everett irom any and all <br /> �— --- --"I claims for damages[hat may arise because of instal�a- <br /> � I" LIP tion and maint�nance oi the improvement hereto . <br /> applied for and further a�rees to remove same upon <br /> �30'—��_______ I 30" I notice from the City and to replace pu�lic property , <br /> -���-..� <br /> dam,.�L thereby. ///] �j <br /> � �"�/��—� 6�/ (�./'",9—. . <br /> � -�: nalth o�Ap ic�j <br /> �� - � .�� <br /> I COPY Of- THIS APPLICnTION TO � Addr ss �` ) 3�7 ���,�1 <br /> BE POSTED ON JOBSIT -C � � '�7�0 nyi�r�2 ' _�,� . �G/'�,.jy �, <br /> C4LL ENGINEERING DEPL 259�891 t '�, Telephone Nu�nb � <br /> z,�`s3 9- <br /> , _ <br /> � i 2�; I10URS ftGFOR� CC�PJSTRUCTION' Date <br /> — - � /�— /z — i� ��% <br /> CHECK LIST Fee <br /> Water Vaive Dept.9 �o Is <br /> Drainage <br /> Curb&Gutter Engineers � � �� <br /> Sidewalk Water `� <br /> �� Stree[ <br /> �� Communications �� <br /> ns ec or s i ture Traftic � <br /> �-- Planning . <br /> ate <br /> Remarks <br /> Note: Original to Cusmmer — ' <br /> , �o�� �o F��� 10�2 9 — <br /> 1 Copy to Inspecror � �UP� 5��� <br /> � ' � <br /> Datc Ap rov�d <br />