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APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br /> everet! <br /> � �_0137 <br /> CITY ENGINEERS ��_G /' <br /> EVERETT,WASHINGTON PERMITNO. `�" <br /> � The Undersigned _ �6��h�Tc�N v , �/�11�1 <.�,?k=N1? <br /> Herebyappliestorpermissionto l�Af�T1�4 .`�{ k�loc IL �L{..�=-�.I - (�F hll ��� <br /> �J� `� CYii.1�ES - �7 �(./>�C l.�vl�-���'�rL/2 �aiZ T'l_I4SN �ZF/'�i 6 V 74C. <br /> At the toli�wing location_�H.t .3� 7� 7� n�1?V �j=�_i��/S_ <br /> SKETCH <br /> �Work to be do�e) <br /> �/� ��� � <br /> � 1 I ' I <br /> � 3325 332 i .3319 / <br /> , <br /> � i � '----= <br /> i_ _, <br /> � <br /> � DUMPSTE/2 <br /> - .3�PPRIX� <br /> ALLE7 � <br /> DRIVEWAY SECTION The undersigned owner hereby agrees to held and ' <br /> NO SCALE save harmless the City ot Everett from zny and all ' <br /> - - �� claims for damages that may arise because ot installa� <br /> � q ,, , tion and rr.aintenance of the �(nprovement hereto <br /> I 30' O" `g`i"� � aUP�� �and furthe� a�r es to remove same upon <br /> r� � � -- no ce fr ihe Ciry n to replace public property <br /> d mag�h by. � <br /> ����__� �FtGa� Q-�- <br /> Signatute of Appli ant � �, <br /> ?� G G S/.'J�= Cv-rc•t <br /> ' �nP'r' oP THIS APP!.ICAIION �fo � Add ess , <br /> ' ;'.i. POST[D ON JOBSITE. I �c�.�--�Z lj � � <br /> _ I Tele hone Number <br /> I Cnl_i [NGINFERIiJG OEPT. 259-z38i 1 ��.+ P-� ��� � <br /> L3 <br /> ;'-1 'iC:!IHS ;?CFONEGONSTRUCTIOfJ�� �.7 , Det�� <br /> CHECK LIST � � Fe� <br /> Wacer varoe Dep,t. Anprovals <br /> Drainage � � <br /> Curb &Gutter Engineers,,,qqq/� �J����� ✓ 4 ''/�-��� <br /> Sidewalk ' ✓ Ti%Lb+•Q.-+Z <br /> Water \ • <br /> . " j� ' �_%�" �, Street /,-.`-__�.»�.L_ <br /> _�� �l � � -ii . �; <br /> ' - %�/�� Communicatiy s -7G�/_�--�-o-o <br /> Inspectcr's 8i§nature Traffic ��� �Q�,�.C.�� j/.S" 7s� <br /> 0 <br /> .� . � , ' , Planning�;,��� � � <br /> --�7�—--- <br /> -�ie — <br /> k/"�l c r���s — <br /> Remarks <br /> Note: Original [o C�stomer - <br /> 7 CopY to File 1���7 <br /> 1 Copy to Inspector Approved by � � � ���� j .�' � � ' ��'��L <br /> ,._5 _,'n _,"_,`- <br /> Date Approved <br />