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~ �— APPLICATION FOR RiGHT-�S��Y USE PERMIT 11`Z 7 8
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<br /> CITY EN� N' RS �/� PERMIT NO.��~/ �`
<br /> EVERETT,WASHINGTON ` C�
<br /> The Underzigned,_.�y�� �� v ��� ' t o �` �Sr 9A Pf/�T r N n'r H -
<br /> Hereby applies for permission to
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<br /> SKETCH
<br /> (Work to be Aone)
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<br /> VE Ti�`�d�t� �� �p�/� t�The undersigned owner hereby agrees to hold and
<br /> � — save harmless the Ci[y of Everett from any and all
<br /> kDI QL _�l � claims tor damages that may arise because of instaila•
<br /> �T 0�� tion and maintenance of the improvemeM hereto
<br /> ��� P applied tor urther agre o remove snme upor.
<br /> �30" �i f ,� ��~������5 no c f m the City and o�re�pj ace�pu�blie property
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<br /> Signature �Iican:
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<br /> ;;pP;' OF TH!S P.PPLICATION TO �� y - � � (o �.j
<br /> 6E POSTED GIJ JOFSITE. Telephone Number
<br /> C:+LIEidGINEERING �EPT. 259�6811 � ',�ne- �8 � ���
<br /> 2d NOURS BEFORE CONSTRUCTION Date
<br /> CHECK LIST Fee /�/o ✓�e
<br /> t"Jater Valve Dept. ApprovalS
<br /> Orainage
<br /> Curh t�a Gutter � En�ineers
<br /> Sidvwalk Wa[er_. --
<br /> Street
<br /> Commimications
<br /> Inspector's Signature Tra��fic
<br /> Planning
<br /> —6 te
<br /> Remarks 112 '3 --- � �--
<br /> App�oved by
<br /> a:u9TOMtw Dzte Approved 9
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