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everett <br /> APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br /> � ��^ i U 141 <br /> CITY ENGINEERS ��_ � % <br /> EVERETT,WASHINGTON PERMIT NO, L <br /> The Underoigned r� �'- �` �— -- � '--�� � ���� •- ��- . <br /> Herebyappliesforpertnissionto CQ/v.s7��'CT �.5 ' /aSAHALi � w <br /> Atthetollowingiocation_ �d Co�B A fy .B � L �r�PiC DR. <br /> SKETCH <br /> (Work to be done) '� <br /> / <br /> NElnl ASPHALT D�W <br /> - � <br /> �DGE aFEXlST1NG <br /> A SP!�A LT <br /> ' / <br /> /\40/� <br /> , , ��08 // I�T <br /> ����� <br /> � \�; ��, <br /> � ,�v <br /> ; 8�� <br /> � � Na .scA� <br /> ��v <br /> � <br /> � <br /> DRIVEwAY SECTION The undersigned owner hereby agrees fo hold and <br /> NO SCAIE � save harmless the City of Everett:rom any and all � <br /> �-—J claims for damages that may arise because of installa� <br /> r----- —a.S --- - I <br /> }1" LIP �l tion and maintenance ot the improvement herero <br /> applied for nd (urther agrees to remove same uuon <br /> Y,3o'�-�U �30"�! �4,_� ' �. notice (rorr��the J1y and to///ep�ace pu�lic pr perty <br /> damaged tl re �J// /// /'/� <br /> ' f �!L�1-L:-•�— �-• <br /> Signature'of Applicant �-- �- <br /> - � ' C' �l.' /,L/n / l � J r!-Li <br /> ���JV OI� lhl�� ��.Pi'LIGi:�;Uiv ;1� ^ Address � <br /> I � F �.j. ,�r� �0=4 <br /> . �� POSTED ON J0651TE, . �(J.�1' �� Telephone Number L <br /> � i_�_ Ervnr,F�i3ihc or�,�_ �r,��, ,�, ., 3 �Z_� , " <br /> " ,I=��. ' ;=i1HE t r ;:.I I1� '[.1 i0�,1 � Date n � <br /> � /<�..5 U '�� ' cC'3- �/-1), <br /> CHECK LIST Fee I <br /> Vdator Vaive Dept. Approvals <br /> Drainage � � � 7� � <br /> Curb &Gutier � Engineers�--�� � �' �.�_, `� 3- /�- , <br /> Sidewalk _ Water ��• .� _ <br /> �1. / � .( .l Street���__�.�._�f�—_ ��I, <br /> � '�� '- � � � � �� ��- ��. Ccmmunications '�'� % -'�-D _ � <br /> Inspector'sSigna[ur� � � � .� . <br /> Trat(ic .� .� 3l <br /> , � `-� .�/ Plannirlg.; � � ! i �iv ��y�1-'7$ <br /> �tc — — <br /> Remarks — �— � <br /> Note: Originz' to Cu;tomer <br /> 1 Copy U. Filc � O 1 � � A� roved bv � <br /> t conv to �nspector _1 n_� ,.�� .��._�rr�ri cc.�,_ . <br /> ' � .' ,_ <br /> Uatc,A��,.�rv�:�9;. <br />