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_,_ -. - . ..i'.., � . <br /> APPLICATION FOR RIGHT-OF•WAY USE PERMIT <br /> e�'hretl 1�9 6 3 <br /> e <br /> CITY ENGINEERS � � { <br /> EVERETT,WASHINGTON PERMIT N0. Z� 0 _ <br /> ' The Undersigned / �O�/�7 I U Z� �+ �%� — <br /> i Hereby applies for permission to/� � r' � � � � S ������ � � � � � — <br /> � At the following location�./5_ � ' ` l"� '�� � � <br /> SKETCH <br /> '� (Work to be doae) 1 t <br /> � =/rL'! /Y� .I ��1'�,����, <br /> I <br /> II <br /> I <br /> j <br /> I <br /> l <br /> j <br /> II <br /> l <br /> � I <br /> I li <br /> I <br /> 1 <br /> I <br /> '' DRrvEWIiY S[CTiON The undersigned owner hereby agrees to hold and i <br /> NO SCALE save harmless the City of Everett from any and all <br /> � —J claims for damages that rt�ay arise because ot installa� <br /> r--- � tion and maintenance oi [he improvement heretn <br /> 1�" ��P _� appiied for and further agrees to remove same upon I <br /> �' 30�� ___y30� notice from the City and to rep�ace public property � <br /> � � ' damaged therepby. <br /> �� �� i�( G�✓�' ` vc...� __ , <br /> Signatu of Applicant <br /> ; •—S J �,^- �.l�.c�.4' S� —_ <br /> � ---- - . -. . . -_ , Address � <br /> co�v or- n�i�s r,r���_icn,�ior.i ro ; 2 �,—;� -- �,/(v 3 � <br /> ' BE POSTED ON JOBSITE. i Telephone Number <br /> � <br /> � rpLL ENGiNFERING DEPT. 259-8811 � �S '� 'S� 7 ' _ �� <br /> � Date ,.�. � � <br /> :�� i+oui,�; �sf-Fo�ar cni�si�aur,iion�� '� 5 .,� �� �-�� <br /> CHECK UST ,�ee � �" ,S <br /> Water Valve � ""6�L�Dept. AppfoValS <br /> Diainage Engineers i <br /> Curb&Gutter <br /> Sidewalk Water � <br /> �, Sireet___ <br /> Ccmmunications — � <br /> Inspector's Signature Traffic �. <br /> Planning <br /> ate ` <br /> Nemarks <br /> Note: Original lo Customer —, <br /> 1 CopV to File 10 9 6 3 Approved by <br /> 7 CoPy to Inspector __ __ <br /> Date Approved <br />