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APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />everett 1 � L 3 2 <br />� — 7.,_ / —, <br />CITYENGINEERS PERMITNO.,�'"� J//� <br />EVERETT, WP.SHINGTON'�'—�N � <br />The Undersigne�i ""'�'�*- ^ � � � T' `' `' <br />Hereby applies tor permission to l� ��N� T���C l � �� �' �7 �• �� i� — <br />At the following location_ U fl' ' 7 � 1� U R � � --- <br />(Wurk [o be done) <br />LOT 35 <br />L <br />� rn25 j <br />i i <br />� <br />�XISTINJ eDG�' pF <br />PH V £ �41 £ ,lf i \ <br />ORIVEWAI' SECTION <br />NO SC4LE <br />r— —2v� � <br />�I" LIP <br />30'�___�_.� _---•f•3� <br />�L <br />�V <br />_;;I <br />rL <br />30� <br />NE'W G�N�: <br />4J %�!. <br />� <br />--__ _ _ __, <br />COPY OF THIS APPLICATION TO <br />BE POSTED ON JODSITE. n IUN• L� ��I ����'�° <br />�I GaLL [NGINEFRWG DEPT.259-8811 7" ��" ���' <br />'i 7�i HUU�:• GCFJRE CONSTRUCTION <br />CHECK LIST � �� ��� ///l <br />Water Valve � ' �G%W-"' ��'��'"7� <br />Drainage '"lu li�,.�a.�-^�-- <br />Curb & Gutter <br />Sidewalk �- � - -��i% GOvI �- r<+�.%� � bc,�T-'/'-�. <br />P�,�G�.t1 ���rr,�l t. <br />Inspector's Signature , / �('�/ � <br />��C.4� v �.... , {l, <br />� �. _ <br />/,1' .� I J <br />Remarks <br />1 'tl <br />NO S'CJ� L£ <br />The undersigned oraner hereby agrees to hold and <br />save harmless the Ciry of Everett from any and all <br />claims for damages that may arise because of installa• . <br />tion and maintenance of the improvement hereto . <br />applied for and Turther agrees to remove same upon , <br />notice trom the Ciry and t eplace ?uMic property �� <br />damage��%�/g�re�6y. <br />Signa re f Ap licani +-CS/��� <br />%: s— �i �a.�.lr l�-•, �,,�,� <br />Addresa5�_�y�� � <br />Telepho��i /J �. <br />Date�U. � � �� / Z_ Z_��; <br />Fee <br />Note: Original to Cusu�mer � <br />1 Copy to File ��1 ?� j 2, Apprpve V� '. <br />1 CoPy to InsPecror ,(� •- l �• �i <<sL� U��i Z 7� ', <br />� <br />D Ie Apptoved � � � <br />