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<br /> APPLICATION FOR RIGHT-OF•WAY USE PERMIT
<br /> everen
<br /> e �0666
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<br /> GiTY PNGINEERS
<br /> EVERETT,WASHINGTON PERM1^�IT NO. %��- ` � "��--�
<br /> '�, The Undersigned k,=i,� �n, �. -.;�>C;'i; �n.l
<br /> Hereby applies for pertnission to i�, i�7> ,%� l i,. ://- , i�: ;/ . I i � � i'. .,f,,,. C i-.
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<br /> At the following location 7�.._ ,7/,' ' � i�-:, i /�>ii T o. � {,� r�.,� �1„/, z;,� Y, / . - �I � .
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<br /> I ORIVEWAY SECTION �., _ _ _ ;� ' �� �� The undersigned owner hereby agrees to hold and
<br /> NO SCALE � ���'-�•��- save harmless the City of Everett from any and all
<br /> '�� ---"'+ � �.,+;;j �:� �, ;.� ;�.y� t��.u'claims for damages that may arise because of installa�
<br /> � ��•� ��p �— tion and maintenance of the improvement hereto �
<br /> applied tor and further agrees[o remove same upon
<br /> . �30, T 30
<br /> - �------------�--�� ,��; (. ���,, b!���� tice from the Ciry and to ieplace public property
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<br /> � COPY OP THIS APPLICATION TO ' ` I' �� '��� � � � � ' �� Address � ��� 7�
<br /> BE POSTED ON JOBSITE I��- � �� -• � ���^� C���> - /J,t"i 1 S �
<br /> � r Tele hone umber
<br /> � CALL ENGINEERING DEPT. 259�8811 `� �6 !�(t � �� .�
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<br /> ', i4 Nc'4�R5 [IEFORECONSTRUCTION� Tit; a��P_) �1,'='�f Dae -
<br /> CHECK LIST ^�=Tt: Al�[Y �Esu,u haoQ �h �"����� Fee /•,—., - -
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<br /> Water Valve io c� vsi» �T n��.�, Dept. �pprova�s
<br /> Drainaye n° crc�+s�.en �oc.� r��[ ' - ., i) ., ,,
<br /> ' Cw�b&Gutter �ti o z" Co.�r»c T[ � T� � t� /j F;g;neers��_:, /!��1�.�r
<br /> Sidewalk �ctis cp n �p�+,..�, � 5� C �,��
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<br /> COfOff1Uf11C3I1005
<br /> �nspector's Signature TraHic
<br /> , Planning
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<br /> Remarks
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<br /> Note: Original to Customer r ,�
<br /> 1 Copy to File � �6�?6' ' .
<br /> 1 CoPY to Inspecior � APProved bY y,��_ . 1..��. _ _�
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<br /> � Date A -�—
<br /> pproved
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