2323 PINE ST 2016-01-01 MF Import

_ r - everel2 APPLICATION FOR RIGHT-OF-WAY USE PERMIT e 10�33 CITY ENGINEERS ��J � � '� � EVERETT,�VASHINGTON �J, / /� PERMIT N0. The Undersigned _ /v//� j��/1/�G- �,,�� - , Hereby applies for permission o CD/VST.P_l/CT S/��(N�4 ,� 4/1/ �'/TY — - /P—O L � At the following location z3 23 P/N T S KETCH ---------------- ------ —---- __ ----- � (Work to be done) /�LLC Y ' , � � -� n/D�RLE �p��r , 2323 � 80� NEW C4NC,E.'ErE SlD�EWAlK � I � _ _ — CX15TlNG SIDEWALK �I PI NE Sl: ' ; --- -- -- � DRIVEWAY SECTION The undersigned owner h:reby agrees to hold and , , vo SCa�E-- save harmless the City of Everen from any and all �, r--- - � claims for damages that may arise because oi ins[alla- �� i" LiP �6�� tion and maintenance of the improvement hereto � � ' L30" I gp� I applied for and turther agrees to remove same upon ! � t_--�—�— �1'��—'7 notice from the City and to repla public properry ' i damage -lhereby. � ' �� .��_�� � Signaturc o App icant � � i ---- ------ --- -- -- - ' �. COPY Or THIS APPIICATiON i0 � Address "' I _ __ —.� � �'(i ';. � BE POSTED ON JOBSITE. � . _ / ` -- I CALL EPlGINEGRING DEPT. 259�t3811 I � Te�ephona wn oa.._ 24 HU�fiti Rf_FORC CONSTRUCTION - � Date � CHECK LIST � />�� ' /7 �- Water Valve Z-ZS"7Y Fee Q r- , Drainage ��/� �u�P�P als/ � Curb &Gutter � Engineer - ' ✓�"�-R�_ ee_ � ' Sidewal.k ` . - � ( , � ' Water _:�� - ��.� �'� � � �� Street � , �� � � � • '' Communicatio s�l i a�C Inspector's Signature ,� - 9 � " � Traffic `. � . . . �� -� �� P�anning-� ��.� ��r,��! • 7fo—�) . -�-« , ,.� �Tu �Z�_ ; . Remarks �� r �„ /� �� O1 )�' Note: Oriyinal to Customer V �� 1 , �o,�Y to F�� 1013 3 / , � 1 Copy to Inspector �'f� t r �•,, � � / ( � ��Approve ,, /� � �',. _ ��-/��' L�Gr�' J �i�,.S � � ' � ' � � Date Appro,�d �