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f . <br />� <br />'+. _Y C1'CfCll <br />;: �� <br />�:� <br />CI7Y GNGINCERS <br />GVERLTI', YJ/1SHINGTON <br />APPLICATION POR RIGHT�pF�17A1' USG PCRR1IT <br />110G5 <br />.1 �� <br />� <br />PERMIT tJO._� � `�.� �/ <br />�', 1 � � <br />Thc Undc�siqned ��ri�'-y,L'-� _ �il�nr�� . <br />�:3 /.t�; '' � ' r rit ,..,- � �' <br />Hcict�y aPplics tor pen�lyssi�n to �L��%' +� - + 1�2:t_1'�_.= �:, � , ��:•__ f �r_`;,�, :, .. ... /��r?L- -?__. - <br />f ..�ahr^-�..�„ " <br />�_: .� ^ r. ���• ae-�... .. �_� :^ •"/ 9.'•��,. n' � .. , . , � � /, i L : - � n.A' C n/ '-- - i r <br />— �4y �Jr_��._� '�4'�.L��_'u��L�.)r__i�� :i��..•• i n y�_�_+1Y:i�1�_ � <br />Al thc (ollowing location�__�%��_j.,° �'�� � /'� �. :�! �__ ._ __ � __ <br />(Work to be donel. <br />S � r .�� ��%�'C F/ �� �� <br />�3�= � Geal�t7'�=`=%. <br />�L ' /�� M <br />�f <br />Dl71VE�V'AY SECTION <br />NO SCALE <br />f'------ ------� <br />�1' LIP � <br />�__�___ <br />I 30'�y__ �_.___'_'____.4.3�...I <br />�._ <br />COPY OF THIS APPLICATION TO <br />BE POSTEU ON JOOSIT[. <br />CALL ENGINEERING DGPT. 250�ffA11 <br />24 HOURS GEFORE CONSTRUCTION <br />(;uib ti Gvttcr <br />Sidewelk <br />Inspector's Signature <br />UJ11• <br />ks <br />Noto: Ori9inal to Cus�nmcr <br />� c�,�� �o r�i� 110 6 5 <br />1 Cupy tn In:peetor <br />e <br />The unJersigncd owner he:e6y agrees to hoid and ` <br />savc harmless the Ciry of [verett from any anA , II <br />elaims foi dama,es that may arisc becausc ot installa� � <br />Lion and main�r.nance ot the improvemeni hcrcto <br />applicd for and (urthcr agrces to rcmovc samc upnn � <br />notice from lhe City and to replace pu6lic properry •, � <br />dai ed IheieLV. . . i <br />�:_��,-�/'� 2� _�'«.�!�_. <br />SignaturC of '.pl�lj tnl /�/ � /,�. I <br />J.�_f' �7�f',�zn��C ��f=���'—i : <br />AJd�ers;� / Jf.�G�� , <br />' C?Z_.tiT ^_ _.' �� �' L� — i <br />Tclephmic Numbcr � ' <br />�J=Z_7 7 c <br />Datc f <br />hcc�'�7�y= <br />Dept. Apqp�rovals <br />[nqinr.crsy ��c. fr��,,,r� <br />Water__ <br />S(rcel <br />Communication; <br />nni,�a��d bv <br />�1atr AI'Ptovrd <br />