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_ l <br /> APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br /> evcrett <br /> . e 1Q319 � <br /> , <br /> CITY ENGWEERS ���/�/ I <br /> EVERETT, WASHINGTON PERMITNO. CO . <br /> The Undersigned ��f�/i%1/rI-T(y-� .(l �% F��C �� <br /> Hereby applies for permission to L L1IU> Tl�'U !_ �T ±� �� � �'l �J' i-�i r r'�L � �1�i�. � <br /> At the following location 3 2 1_!+'1 c G /L / �1/ f- ' <br /> � 1_i =1' � <br /> SKETCH <br /> � (Work to be done) � ��' � _ <br /> �� �� V � ;�z ; <br /> � ���' ;, o i <br /> \ ' G �� V � . <br /> j 1��� V� �a1> r� <br /> - --- ,� X i `� �'�17 � � �� <br /> �--- f �., <br /> �� �� � <br /> � � .� 2 � ; <br /> � �-- <br /> � - � �/ ; <br /> � �, <br /> � <br /> , � �, <br /> ' -_ e`';:r�;, � � <br /> - =i: ',,�: \ , <br /> I IVEI.0 I-�SI�H/-iLT UIUJ \` �° � <br /> �, 12" r 'INI�IU ('1 Li1LV� I�T � � <br /> I <br /> , . i <br /> ; <br /> rr � <br /> DRIVEWAY SECTION The undenigned owner hereby agrees to hoid and �, <br /> NO SCaL€ save harmless the City of Everett from any and all � <br /> �'--- �S — � claims for damages that may arise because of installa� �, <br /> � �I tion and maintenance of the improvement hereto I <br /> �i" LIP <br /> � applied (or and (urther agrees to remove same upon <br /> � notice from the Cit and to re lace ublic ro ert <br /> 30'+-- �A---�30�� Y P P P P Y � <br /> dama ed hereby. �, <br /> D?,(Ih�. C3 �'_ L L7[J i�1, "� y�5- � ,�����..`�_ �i <br /> � Signature of Applicant <br /> l/- 3 - 75 �2 /�-� � �s..���rrusz� ; <br /> COPY OF THIS APPLICATION TO l Address , <br /> 6F POSTC-D ON JOBSITE. 3 SS- � y� U <br /> �• C��I.I.. ENf,INECRING DEPT. 259�fl811 Telephone Number ', <br /> � /- y - � .� <br /> .'-i IIOUGS UEf-nH� CONSTRUCTIONi Date <br /> _ _ _ _ _� ��h �. //���� <br /> CHECK LIST Fee <br /> ', Water Valve Dept._ Appt'ova15 � <br /> Drainaye � � ' <br /> Curb&Gutter Engineer � � �����-��C�� ��' �% � I� <br /> Sidewalk Water d ' ���� � <br /> Street ��1 <br /> Communica ions`_� `� =� �-��'� �� .�-7�` <br /> Inspeclor'sSignature j J� '�- � // �:3 - <br /> Traitic <br /> Plannin�V � ' ' � _ // � 7 J� � <br /> -6atc - — <br /> c1 :�" <br /> Rema�ks � �. <br /> Notc: Original to Customcr <br /> , �o,�Y to F;�� 10 319 <br /> i CopY to Inspector ApprbveQ �v? �,� � � �. <br /> �Cf✓=-;( i_ "`�;/�-;° .�`. /: / Y- �... <br /> Datc Ap�roved <br />