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everetl <br />e <br />CITY ENGINEERS <br />EVERETT, WASHINGTON <br />The Undersigned !.i 1. o !.L : <br />Hereby applies tor permission to <br />APPLICATION FOR RIGHT-OF•WAY USE PERMIT <br />10002 <br />PERMIT N0. � 7 � � / <br />�' <br />At the following location /iJ // �/� �, /; i L 7 c J j� L�/ 1? <br />(Work to be done) <br />DP.IVEWAY SECTION <br />NO SCALE <br />� � � <br />+I'� LIP <br />I �30�_—_—__—�M3O1"1 <br />��� COPY OF THIS APPLICATION TO <br />BE POSTED ON JOBSITE. I <br />I, CALI. ENGINFERING DEPT. 259�8811 � <br />I ;, 3; HOUHS L'FFORE CONSTRUCTION <br />� CHECK LIST <br />� Water Vaive <br />Drainage <br />' Curb & Gutter <br />Sidewalk <br />Inspector's Signature <br />Remarks <br />Note: Original to Customer <br />1 CopY to File ���� 2 <br />1 Copy to Inspector <br />_� <br />�/ � j- / % / i/ /i ����/ <br />� <br />The undersigned owner hereby agrees to hold and <br />save harmless the Ciry of Everett from any and ad <br />claims for damayes that may arise because of installa� <br />lion and maintenance of the improvement herero <br />appiied for and further a9rees to mmove same upon <br />notice from the City and to replace pu6lic properry <br />damaged thereby. <br />/ !' <br />., f c �� -1':. V n� <br />Signature of Applicant - <br />_l� � 7 ' i � .� !�� l ��i�li�r,i .� <br />Address �' - � <br />. —� <br />7 �i .� i 3 ,`, �� <br />Telephone Number <br />- - 77 <br />Oate �—t, /��� <br />Fee <br />/ (i ' Y'�i <br />Dept. A prova/ls <br />%" / ' �/-r.��f� <br />Engineers � <br />�� � <br />Water , <br />. i <br />Sl-. :. n�i1�_ Slreet � - -�'-:4!^7 � <br />Communications �� <br />Traffic � '� <br />Planning <br />;i,i� � <br />�'n.,.a�C_i-e.�;i.� .h—.,..� �a .,r <br />.+ <br />Approved by <br />Datc Approved <br />r <br />