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.. __ . .__,-:::. . <br /> APPUCATION FOR RIGHT-OF-WAY USE PERMIT <br /> � everett q q n�p ' <br /> � � � 11l? J <br /> I <br /> CITY ENGINEERS �I � 4? <br /> EVERETT, WASHINGTON PERMITNO. ��J <br /> �, The Undersigned �� /� ����� � / � <br /> ' Herebyappliesforpermissionto Cvi f� 3fl S (�J ' rin. /•i SO�i�ir l�'�'� f'�-�.'1'�/ L/h/+ ih/ I <br /> �l�Nrll d ,r ia��l as � �.s= l . ��r�. Pt.? rl�i�,,.� uN�.�;e c�v<�,.��r £'rT��_ k�:^CN:a. � <br /> i <br /> �' At the following location 2/fJ� /'.�?�t"$ , <br /> ; SKETCH ' <br /> � (Work to be conel ' <br /> I <br /> Nor� , <br /> � /. 7Nf,{�' �.5 Vir��F. K SirlvvOi��G on� 1"r1_f S/oc b✓:IaK . I <br /> � 1 . 7/7�CE /5 !� IaILF/ �di:3 1.,�� 7r/ /V� �.%7ii�n �(l�aii`I <br /> I 3 M� f�i-�GG�-��-;- v✓.�NT5 I o ? {'i�'ir/ 7�{���c ��/ r:/� c'v,Zd ��+UD i , <br /> /NT� T��'= g'`T��t. <br /> j� vs,� a �" , T�N v,l,a�r P� r'%. <br /> t� H� yJJ✓LJ �.IICY� I <br /> �i � <br /> I <br /> i � <br /> I <br /> i srr ,���'-�r�,� r��re <br /> I <br /> �� i <br /> i <br /> � <br /> I <br /> I <br /> , <br /> il <br /> DRIVEWAY SECTION � The undersigned owner hereby agrees to hold and �� <br /> NO SCALE save harmless the City of Everett from any and all �, <br /> ir-- —� ciaims for damages that may arise because of installa- ;I <br /> � � \ �I" LIP tion and maintenance of the improvement hereto <br /> applied tor and further agreer to remove same upon , <br /> I30'�—� _____.{.30'� notire from the Ciry and ro replace public property <br /> , damage ther y. � . <br /> � <br /> Signature o Applic <br /> ICOPY Of- THIS APPLICATION TO Ad e ^�' ��y—,�, /' , ,\^ � �Q <br /> I BE POSTED ON JOBSITE v� --` ' �'�"' �,J �� � � <br /> Telephone Numbei <br /> � CALLENGIN['cRINGDEPT. 259-&til'1 0'1 `.� Z'�,� I <br /> I I74 HCURS FEr'OR[ CONSTRUC_iIONI Date <br /> � CHECKLIST Fee /v0 '`%� <br /> Water �'alve Dept. •p��-pro�I5 <br /> Drainage FI ' ///.' � <br /> ' Curb&Gutter Engineers � �/./-�'��u-+"� _ '� <br /> Sidewalk Water � <br /> ��, Street � <br /> ' i <br /> Communications , <br /> � Inspector's Signature Traffic �� <br /> , Planning � � <br /> ate I <br /> i <br /> �� Remarks � <br /> j Note� Original to Customer � i <br /> �, , �o�Y �� F;�° 11039 — <br /> � i Copy to Inspector Approved by <br /> ' Date ApproveJ � <br />