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evcrett <br />� <br />CITY ENGINEERS <br />EVERETT.WASHINGTON <br />APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />10069 <br />PERMIT Np, ?T-�(J I <br />7 n 7 <br />The Undersigned __ ��/ �iC� r� c�- i� � K�, y, ry <br />Heieby applies for pertnission to �' O f' '6� C�j:q /"G, 7�G �%/,�� �J G �%� <br />At the follo�ving locatiun r: d��,% � �� �J � l; n rn x �(i <br />1—s���_�__L_ � r c `.��u 5 � 1� . <br />SKETCH <br />(Work to be done) <br />� <br />NEW CJNCRFTE <br />�KLAHOMA ST <br />DRIVEWAY SECTION <br />NO SCALE <br />�--- � % � --- --.. _ . .-J <br />j I'� LIP J� <br />�30.�..__ . _ . ./_�' _ . _..�.30'J <br />i COP1' Of THIS Hi•i'IJCAIIUIJ TO <br />! iSE POSTEC ON JORSITE. <br />� <br />C4LL G'.GI�!6[li!���:G DFPT. 259�II�'�� I <br />. ?.: I :i'U: i:: p, �-pL �; l[ ::ONSTRUCTION <br />CHECK LIST <br />Water Valve <br />Drainage <br />Curb & Gutter <br />Sidewalk ! <br />�� <br />� � �—�'-�— <br />Inspector's Signaturc <br />�_i< <br />ate <br />2.L �9 <br />'5 ` <br />xrs ruv6 s w <br />i?13.i yn' __GUTTERS <br />/J o <br />SCaLE <br />The undersigned owner hereby agrees to hold and <br />V� save harmless the City o( cverr.tt from any and all <br />`y �-� ���-� claims �or dama�es that may arise because of installa- <br />tion and maintenance of the improvement hereto <br />appiied fur and further agrees to remove same upon <br />notice irom the City and to re.place public property <br />/11- �o " �'�i <br />Date �7. SQ �� L_�i-�Q'��/ <br />Fee <br />Dept. Approvals <br />Engineer �� y �L_ � i � I ��%'� <br />Water_ i��`--�/ �1-�-C%!-�`e'�-e--Su�fj'� \ <br />Street � � � <br />,_ �y� --�- � �-- _�� , <br />��` Ccmmunicatio ���� � <br />Traffic � ' � - � , io i.y' j � <br />Planning` ' �. � /O'A'- 7¢ <br />�i-y'4��'-il ���\ A)f� �jf �G1L }(�.1���-1 \I( l <br />Remarks <br />Nole: Original to Customer ,�, <br />1 Copy to Filc �� n��. <br />1 Cnpy to Inspccto� <br />Approved by — - ---- <br />—L— <br />Dale A'pproved �} > <br />(il� •'�, �7/'-f <br />