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, <br /> ► <br /> APpIICATION FOR RIGHT-OF•WAY USE PERMIT 112 7 �u <br /> everetl ` <br /> � e <br /> CITY ENGINEERS PERMIT NO.I�~/ �� <br /> EVERETT,WASHINGTON <br /> � �sr c— �yur'cH . <br /> The Unaersipned �'=� Kt ��C'�H W r--'r' 'o !' i SA'Pr' <br /> Herebyappliesforpermis;ionto ! L�CF �ii'sT , 7 %"� S'r [Hvr'"lJ '-�f�✓?�F�C�>ln,N_S/GN= <br /> -F >� � Lo .A- . n o � � fz n i <br /> At the following Ixation st� .}�'''�' � " � � Var4s U s l�nl'� �O�t S <br /> SKETCH <br /> (Work tu be done) <br /> ;.: v -- _ <br /> � <br /> , <br /> � \ <br /> , <br /> `� �, ��\• ,L,,� � <br /> ��' 1u� <br /> �� �. <br /> , <br /> � <br /> ,� <br /> DRrvEWAr SECriON The undersigned owner hereby agrees to hold and <br /> {.� NO SCAGE_ save harmless the City of Everett from any and ail <br /> � � --� claims for damages tha[may arise because ot installa- <br /> � ` — tion and maintenance of the improvement hereto <br /> ��I" uP applied for arther agre o remove same upon <br /> � ,o�1 � —4— . yf„30� no ce fr m the City and (o rep ace public property <br /> 1'—T-_- ----- - � d� d ther by. � <br /> r ,C,,�r,^ <br /> Signature licant <br /> , � A� ��� c Firsr dn�____�arv�et� <br /> - - -� - �-- - ---- A dress <br /> COPY OF TH(� .�PPLICATION TO Z�y - � � (o (p <br /> BE POSTED ON JOBSITE. Telephone Number �+-� <br /> � CALLENGINEERINGDEPT.259-6811 � �,v'nt �'� � I1 'Fi <br /> � 24 HOURS 6[FORE CONSTRUCTION Date <br /> ' CHECK LIST Fee /�/�� i� r--_ <br /> � Water Valve pt. Approv:�is <br /> Drainage <br /> � Curb&Gutter Engineers <br /> Sidewalk Water _ <br /> � Street <br /> � Communications <br /> iInspector's Signature Traffic_ <br /> �' Planning. <br /> �ate . <br /> I <br /> Remarks 1 I �� <br /> � ? �ti <br /> Approved by <br /> CU.YPOMEft Date App�oved � <br />