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' everett <br />e <br />CITY ENGINEERS <br />EVERETT, WASHINGTOiJ <br />APFLICATION FOR RIGHT-OF-WAY US[ PERMIT <br />10749 <br />PERMIT NO.,_/ �- �� 5 <br />Thr. Undersigned!"'/�;. 1 -"/ = NAJA,� <br />Herebyappliesforpermissionto. ���n/5rl�,.r-Y' ,p -y�-' �.}Sn.��.�� Y �)lvi <br />"�-- <br />At the foilowin� Iccation��_Lq -^i�„� .� �,� i� <br />SKETCH <br />(Work to be done) <br />DHIVEWAY SECTION <br />NO SCALE <br />I�-- . --- _—� <br />I <br />_�I_' LIP �� <br />�30+_ _ ' <br />— - – -.4.3p'J <br />i <br />� GCi'Y Df� 7Hl`��I'i�l 1C���1 r0'.' lt; �� <br />i;,C PpSI��D ON JOB:>Il E. , <br />� c'l1L�.GNGINEER�NG DEPT. 259�8811 �� <br />, � �iOIIRS Ci[i-0f?L CUNSTRUCIIOfJ, <br />CHECK LIST <br />Water 'Jalve <br />Orainage <br />Cur6 & Gutter <br />Sidewalk _ <br />Inspector's Siynatw�e <br />�itc <br />Note: Oripinal to Customer <br />, �o,�Y �o F��� � 07 a g <br />1 Copy m Ins�;ectur <br />S _F _f i'� ri .�-,' C' /f ,_ /� <br />i <br />p.;: c�-al�.d�e�n�t�...,�1��.,, <br />, <br />�� .. ,i ,i,..:..-..�. �..: <br />The undersigr.ed owner hereby agrees [c hold and <br />save harmless tlie City of Everett from any and all <br />claims for damages ihat may arise because of instal�a� <br />lion and main[enance of the irnprovement hereto <br />applied for and (uriher agrecs to remove same upon <br />notice from the City and to replace public property <br />da egi�d thereby�,' `, / <br />� ,�, ,G�IA,� <br />Signdture Appl�ant - -- <br />L: � r. � . i C (�T,t't' � "fCrLrf'$ <br />Address <br />/✓�,-Y <br />Telepho� Numbe <br />Date � ',�. <br />> <br />s� � � <br />Fee —T'�`— <br />Dept. Approvals <br />i � <br />Engineers r �,�,5' �_ <br />� � <br />Water_}i�l-'�S� �.%% / . ' �a�v . �.���t-�.�il. <br />Street �!�.��¢� � �- L- ,�/_� � �— <br />Communications_ <br />Planning i <br />/ <br />, , . -� �..�p "'-'��c.n .�7 �,r�,.1-,�, ��t r��'- , <br />� <br />� <br />Approved by <br />Date Approved <br />