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�- � r�. <br />evr.en <br />�� � <br />���� <br />CITY ENGIt;c�AS <br />EVERETT, \:�:,SHINGTON <br />- -� ----------__.--�-- <br />APPLICATION FOR RIGFIT-OF-WAY USE PERMIT — <br />The Undcrsi9aed _ ^",� � /' / C �e;r �-r �•��/ <br />Hercby applies fnr permission to __�/c : �_:_� - � _�� � ,� � <br />At the followin� tocation �!�% �•r <br />—_:i..� . L%, •� J:./—�': ;�i� -- <br />(bVork [o bc done) <br />� <br />OBI1'FWAY SECT10� ' <br />NO SCA.E <br />�"'-----• � <br />(�____ 1 �' I.I P <br />�:i0" � '__4'_—_ _—__ � <br />._�__ <br />CUPY Of T:'.;� P,PPI.IC��,�fION TO <br />I6:: POSTED C;: J0351TL. <br />I G�LI Ef�'G!'�:�ERIiJG D[PT. 25fi��E11 <br />�?•i .'�IOURS ii�i�ORE COP:SI�i:UC71UPl <br />I ---- <br />- _ _- - -- -- -- ------- <br />CI-IF:CK LIST 1_ <br />4;'�t,u V�+:v_ ' <br />— 1-- <br />I)raint,ic � _ <br />Q �L 7': Gu:Ls j-' <br />Sid��t'_��i4�_._.�� . <br />..;c,�n�cto%s S�;n.iture <br />, ,,,,.,_. � ---__..__.._.. <br />,.-. �y.. .;:WCu•.loinc� <br />� . .�� �;I,• ' � . <br />i ... . . :a In�;;��:;or � . <br />sc� ,�.�rac-f�� <br />�i --/� � %' 7 <br />107�9 <br />PEflMIT NU.�_ <br />The undersi9ned owner hereby agrces to hold and <br />save harmless the City of Everett from any and all <br />ctaims for damages ihat may arise because of ins[alla- <br />tion and maintenance of the improvement hereto <br />aPP���'d for and further agrees to remove same upon <br />notice from the Cty and ;o replace public properry <br />dai �ed there� /r � <br />%����� /� <br />lkG✓ �' <br />Siynature'_ qp ai��/Lti�. <br />��Z ri, `�� �( � � �PJJS <br />A��ress ..�.__el_��.,� <br />—3���C;: d' <br />Telephon�ylnl� <br />' 7 � <br />Date � ---- <br />Fcc - -- <br />Deiit. Approvals <br />Enr�inpers_�_._ _ <br />'/ ` <br />w::����- '' , J• /' . <br />... . —�c�1.li_`z.,�+"L�`�>,�. � � <br />Ccmmunir,�tions__ ___ <br />l'ra'(i^------- --- <br />�PUroved h•1 <br />. �; <br />