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� I <br /> I - APfUCAT10N FOR RIGHT-OF-WAY USE PERMIT .. ' <br /> everett ir^� <br /> ! � 10177 �, <br /> ; <br /> CITY ENGINEERS �� / / <br /> . EVERETT,WAShINGTON , PERMIT N0. •-J 4n , <br /> I The Underoigned //�7;� /��f'�/�.�1.�T��!/ ,(� �/ (i����f�� '/ <br /> �, Hereby applies for permission to�_��z'�!l U _IA�.ONFSE CH��C�Y T,f�� <br /> , �3�=ra���.v S/(.L G/ALff ,grvD C�.e,2 <br /> �. At the following Iceation i��02 ����'�r � <br /> SKETCH i <br /> I (Work m be done) � <br /> �I I , I <br /> I �Z2 ' . <br /> , <br /> ; <br /> � . <br /> � <br /> i <br /> � � <br /> - - - - -,- - - -� - - - - - - - - � <br /> �� , � <br /> ,, <br /> , ���sb 5� ���uaL� � <br /> � � ; <br /> , •�� i � j � I <br /> t � �L.J IZ� ' � <br /> .\ — <br /> Ill i -�—�►-'�-_ G N E22Y T—i�E.E ' <br /> � — — � — — — — — � <br /> ; 0 A 4L�5 �� �N U � � <br /> � �� <br /> ��� , � � <br /> DRIVEWAY SECTION �, The undersigned owner hereby agrees to hold and ,I <br /> 110 SCALE ���(� save harmless the City of Everett from any and all j <br /> '. claims for damages[hat may arise because of installa� ���� <br /> � — � tion and maintenance of the improvement herem � <br /> � applied for and further agrees to remove same upon ' <br /> ; 30" _ _ o" notir.e from the City and to replace publjc prqper <br /> da d Me eh rv <br /> � %� � � I <br /> �f1,2��7�r��i��f��.�G97v � <br /> , �ignamre o App ican /.� �� <br /> — -- ��r���lt ���� ' I <br /> COPY OF TFIIS APPLICATIO� TO � t Address <br /> �, BE POSTED ON JOBS�TE. � (t�-V� �'S� _[ _'i S ,�1 I <br /> J Te ephone Nu ber <br /> CALL EN.iINEERING DEPT. 259�8871 � / � 7 � ' <br /> 24 HOURS 6EFORE CONSTRUCTIONJ l Date n/ <br /> CHECK LIST � Fee l�� ��E i <br /> Watar Valve i I <br /> Uept. Approvals <br /> � Drainage � %/ ,' i /� "� ., <br /> ' Curb&Gutter i ;�' Engineers - � ' (�sa����cr.� r'�"- -C` � <br /> Sidewalk — 7�5 I <br /> .. � 4i'" Water � <br /> - : . II <br /> �p�� , <br /> Street�! <br /> I � (/�"` � "'"�""'"�� Communications � 4 � <br /> � In tor'sSignature Traffic : �� ' '� <br /> � � i � �� ����� <br /> , C���.. � � Planning . <br /> J <br /> ate — <br /> Remarks <br /> Note: Original to Customer I <br /> , 1 Copy to File 1(J't 7 7 <br /> 1 Copy to Inspector Approved,-6����� ,/ /,. � <br /> �- ✓>`LH..ct t,ci.� �Z i <br /> Datef�pproved � <br />