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�.' APPUCATION FOR RIGHT-OF•WAY USE PERMIT <br />.�" cecn•il <br />�10gB8 <br />� <br />CITY CNGINE�RS � <br />[VERETT, W�SHINGTON , PEFlMIT N0. � ? � � ' /� <br />Thc UndcrsipneJ �/iTfiUF• �,t!oT/)!1 !_ �� <br />Hereby applics forpennission to C��iIS-TiP�_�__��1�_ /7 �:i•."�l.y,`_�;,� <br />Al thc tollowiag location �Y 5���1�l�j%C��,�f�[i'� ___ _ _ � <br />IVJork ro be donel <br />$cC A`tTAGfd"-v'Q <br />DFiVEWAY SECTION <br />I10 SCALE <br />� � <br />_ (�" l�P � <br />r30"i�--�' ---�30,'7 <br />COPY OF THIS APPLICATION TO <br />BE POSTED ON J08SITE. <br />CALL ENGIN[ERING OEPT. 259-881 I <br />24 HGURS DFFORC COfcSTRU�T!OV <br />CHECK LIST <br />Watar Valve <br />Draina9c <br />Curb & Gutter <br />Sidewalk <br />Inspector's Signatura • <br />Remaiks <br />Notc: Original to Customer <br />, ��,�y �� ���� 10 9 8 8 <br />1 Copy to Inspector <br />The undcrsic�ned owncn c�reby agrces to hoid and <br />savc haimless the Ci�.y of Evcrett fiom any and all <br />claims tor dama9es that may arise because of installa• <br />tion and maintenance of the impwvement hereto <br />applicd tor and turthcr agrees to remove same upon , <br />notice from the City and to replace public property.�• <br />dc �n�a�ged thcrc�y. � <br />—1l�.=�/.�i F,�'%'��/�j � <br />Siynature of Applic it r <br />Address <br />Telephone Number . <br />Datc <br />,SL-r � <br />F�� �.�,,,�, <br />Dept. �provals <br />/1 . , / <br />Engiaccrs S� �.1���. ; � <br />Water <br />Strcet <br />Communications <br />Mnro��d �Y <br />Dnte npnrovcd � � <br />