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APPLICATION FOR RIGHT•OF-WAY USE PERMIT <br /> everett <br /> e �;�;_ ;���-���% 10517 <br /> , . <br /> CITY ENGINEERS / �/ '� <br /> �, EVERETT, WASHINGTON PERMITNO. �`{' � IY�"�' ' <br /> The Undersigned_ C,'% ,'. F- ��i ��- '� �- _/ ' / :� : <br /> Hereby applies for permission to :'".�=--/ � !��(� �= (�'_�•:',. , F'7' !. �' -;(C lc�.%.-_;!- •�- .�_" <br /> _ �!i-'�t-' /r . �.i t- � �� : ..�„ r�r- - - <br /> � At the following Ixation �. / � �i- -� �� �'-��� �' j� �. <br /> r <br /> SKETCH <br /> ��� (Work [o be done) <br /> I <br /> i � \`:� 1 <br /> � �� f � <br /> ; •-/1 1 <br /> . �I <br /> �, 2 l % `' L�� i <br /> � '-'h-- <br /> I " - �- �^ - ' � , . _ , <br /> \�a�'af� R� '. ..I I�:i. `�� <br /> I _Z�' �� I ( / ``� �~�� . <br /> �� ti h::7'1 <br /> I __ . I� _�_._,��� ,<C�%� iN�4L,(.,, <br /> - --- --- -��fr/�'���lr�,�'_�� <br /> -� � <br /> c - <br /> '� --�— - - – - — <br /> i <br /> ���i,�i� "-=�7. <br /> i .. �---- -��---'-'=�-t-- <br /> I . <br /> ! DRIVEWAY SECTION , The undersigned owner hereby agrees to hold and <br /> I NO SCa�E save harmless the Ciry of Everett from any and all <br /> � � ----� � claims for damages that may arise because of installa� <br /> , r� +i" L�p � tion and maintenance of the improvemen[hereto <br /> � 30" 30" applied for and further agrees to remove same upon <br /> �-�—--------- --�� notice from the City and to replace public property <br /> � damaged.thereby. ; <br /> � /':<�� ,.; � ; <br /> Signature ot Applicant' " � .� <br /> .� . <br /> i COPY OF THISl1PPLICF,TION TO Address ,�. � <br /> � BE POSTED ON JOBSITE. � - •- =%°� '��j� <br /> ' Telephone Number � <br /> � CALLFNGWG[R�NGDEFT. 25y�atl11I <br /> I ?�; HOUR.4 [;�FORE_CONSTRUCTION� Date — '. <br /> ' , �� % ,� <br /> CHECK UST Fee ., <br /> wace. v,we Dept. Approvals <br /> � Drainage ; � <br /> ' Curb& Gutter � , <br /> Engineers �� "-� ' /�/� <br /> Sidewaik � , <br /> � . ;: .. �� . 'Watcr�_'[—� � ��!�.- � .�%_ . , `:. <br /> `. Street <br /> . ����-�J-G�-� Communications- <br /> . inspector's Signature /1---- Treffic r - � <br /> %�/i �7G � Planninv:� �"� � ' . . � <br /> � r� <br /> -�ate .l r�i:�:..;._�/ - -� %.. lS .. .4�. <br /> i . <br /> ,� ', �� �._:�- <br /> z � <br /> Remar es � � � <br /> Note: Original to Customer <br /> 1 Copy to File �.Q 517 . � <br /> 1 Copy to Inspector Approved by . ' � . , <br /> Date Appiaved - <br />