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APPLICATIOM FOR RIGHT-OF•WAY USE PERMIT � 1 3 6 � :' <br /> everett yy�, : <br /> .� -,�i' . <br /> •, <br /> CITY ENGINEERS �- <br /> EVERETT,IYASHINGTON PERMIT N0. ����� <br /> 1 � <br /> � - <br /> The Undersigned � � <br /> Hereby applies for permission to '<t-�� � .'- - Y�� .�c /�� �--fl dy��=�_ �_�.�. <br /> �• ,,,{� /' s <br /> Af I•(.�`// .�.�� /� �—/Ji.G � ���IMlA4i`��� �I�.Ya�sL� <br /> �.� <br /> At the following location / �v.� T- �' .y,-a.G �..a-Q_ � _ <br /> � - <br /> ,: ! , <br /> SKETCH � • �: ✓� <br /> �Work to be done) . � ��' I <br /> 1 <br /> . .r� l l. <br /> . � ', : <br /> � i; . <br /> i <br /> `' I <br /> �+ v I �U :O �/ --� <br /> i Lci/��R�/� \ I <br /> I '� � � ) I - <br /> Co,t'� l `.L ., �2 �0 ; � <br /> _ _ � � � , . <br /> _ ���►��� �v_ i� ��: _ - - - - - <br /> �K �� l_�oriS � , J,r; <br /> �- � � G,� �i�� .�_7� ``Yivi%✓ �'/'%'<Tf "f� <br /> �hS .�-� Y"u�✓ �.� ���� ,�.., <br /> i�-' <br /> DRIVEwAY SECTION The undersigned owner hereby agrees to hold and <br /> NO SCALE save harmless the City of Everett from any and all <br /> • j — ---� claims for damages that may arise because of installa- <br /> p� �ip tion and maintenance of the improvemen[hereto <br /> applied for and further agrees to remove same upun <br /> �, JO"T 30" notice from the City and to replace�u61ic property <br /> damaged thereby. /Jy n �- . <br /> �/{ /� �L� 1S�L�'/1.(L.f> <br /> Si nature o A licant � S�� <br /> /�J D Z /r/�f�) ��[r,c.a+ <br /> COPY OF THIS APPLICATION TO Address <br /> BE POSTED ON JOBSITE. T ep�e:Ju b��� <br /> CALL ENGINEERIVG DEPT. 259-8811 _ �� <br /> 24 HOURS F3EFORE CONSTRUCTION Date <br /> CHECK LIST Fee��t���� <br /> Water Valve Dept, Approvals <br /> Drainage <br /> Curb&Gutter � . En�i��cars <br /> Sidewalk <br /> Water <br /> Strcet <br /> Ccmmunications <br /> Inspectcr's Signature Traf(ic <br /> . Planning .. <br /> -Tiate <br /> Rcrrarks 11 J 6 U <br /> , 4 <br /> Approved by <br /> "i <br /> CUlTOM6R Date ApprOVed `� � <br /> �� <br />