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^ everen <br />- �e <br />CITY ENGINEERS <br />EVERETT,WASHINGTON <br />APPLICATION FOR RIGHT-OF•WAY USE PERMIT ��� 4 2 <br />PERMIT N0. %�` ' , '� /� <br />The Undersigned ' .�.. �...;' ✓. � ' � �.�] ' / <br />Hereby applies far permission to � —' � ]- � � " � '' �- � ' ' �� " '� � ` � �' <br />_ '� <br />1 _. � Y ��' `/---��"'—'�— <br />Atthe�followinglceation �:i 1 1�� /1/J 2F/k/'� iC'� 1i� <br />(Work to be done) <br />� <br />�---_ __ � <br />� <br />� <br />J <br />� <br />�; <br />fY,i <br />--- - --�.._._--.-'_.—...._ <br />i <br />L�.�:: <br />,;J��a.� �d <br />�jPraR t <br />_1 <br />.y <br />2X�rn9 �" !.. <br />i:,...... fo ... <br />-� Crty�',i'.Ow +-1— ,.-,,. <br />'� � �:�,>�-a.e./ r!�/�/ie/;�. <br />�-- �n ------- <br />---��--�--- ---------�-- ---_. <br />DRIVEWAY SECTION <br />NO SCALE <br />�_ —.___ � <br />I'� LIP <br />30" _- .—___.__---.�.30,� <br />CGPY Or THIS APPLICATION TO <br />BE POSTED ON JOBSITE. <br />CALL ENGINEERING DEPT. 259�8911 <br />7_S HOURS QEFORE CONSTRUCTION <br />CHECK UST <br />Water Valve <br />Drainage <br />Curb & Gutter <br />Sidewalk <br />�� .L,,z , z-..,`tY <br />Inspec} , �s Sig� ure <br />i; <br />ate / '� 7�— <br />_._�c��,��L�.�.__�_ _ _---. <br />Remarks nn <br />���(+G <br />_ �_ �., <br />F' / <br />_ _ �_...�--�:�.�. �_ . � �. <br />� �i <br />The undersigned owner hereby agrees to hold and <br />save harmless the CitY of Everett from any and all <br />claims Tor damages that may arise because of installa� <br />tion and maintenance of the improvement hereto <br />applied for and turtlier agrees to remove same upon <br />notice from the City and to�ieplace public properry <br />damaged thereby. <br />. / !•� '� ._ - - <br />�`-r' �tr, ;. <br />.Signatura of Appiicant � ' , � <br />,'�� �7�1-�t. - ',-:�. <br />'.t, d�i�l` !., <br />nda�e55 <br />='��a - J�i:�; <br />—,- � , _,. <br />Telephone Number <br />y� _�71,_.�,.�,- <br />Date <br />Fee ' , , ' . ...i '. � � ;' , � , �.- <br />Dept. Approvals - �.',.� �; :' ' <br />Enginecrs <br />Traftic <br />Planning . � <br />Approved by <br />Date Approved , p <br />IiE' . �:�.li)!.S COFI" . •. <br />