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. ;. <br />i <br />—1' <br />, <br />���•,`. <br />r'", <br />� <br />ITY ENGItJ_EP� <br />VEFIETI', 1'1k:,liINGTON <br />, <br />APPLICATION FOR RIGHT•O'r•WAY USE PERMIT <br />1��C2 <br />r-•, � <br />i�� Undersiyr.:d i%.. . - L[. r� ' : � -. � . <br />kreby appli_s fnr permission lo __;�'1L `• �' ' ' � �� <br />� ���r'..: � <br />� 19// l+�_lr�_/-JLTi�) f-%1 J" <br />It the (o�low�ng locatia� <br />Work [o be doaa� <br />7� G �J%i /�� /'= r� <br />PEFtM1T NO. ( 7 `�/ ?� <br />� <br />DBIVEI.AY SECTION <br />NO SCALE � <br />� LIP <br />�� 3Q•� � 1 30_' J <br />r� -•y� ---•—••r =, <br />ICOPY OF TFili F�?r UCATION TO <br />� ee rosi �o c,: �oesrre. <br />� CALL [NGI?:`ElitNG DC•PT. 159 6011 <br />IZd lIOURS 6: Fp„L' CONSI"RliCT10�: <br />�-- — — <br />CII[CK I.IST <br />\`la:�,r vaivu i - <br />Dr,iinage I <br />Cu�l� Ya Gutt:r I <br />Si��.w.lk _ <br />In•,p^ttor's 5;naiwu <br />-i���: <br />/� � 7 The undersignect owner hereby agrces to ho�d and <br />�— save harmless the City of Everett from any and all <br />� claims for dama�'es that may arise because of installa• <br />�,,,� �, tion and maintx�iancc of the improvement hcreto <br />°• applied for and fur[her agrees to remove s�me upo� <br />� not�ce 1ro'n the City and to replace pubiic prop^rty <br />damaged ther �. � <br />Si�� <br />ture of A(�Nli�it � �i / <br />� �_ ��' `� . (ni � 4I7h LJr�r�! <br />Address ! l� <br />,�c/�"%3 i t5' - <br />' Tele ihone Numbtr <br />._�_� ' -% % <br />Da[e <br />e��c. a�����ais <br />En�ineer� <br />Water�C(_�4 <br />! <br />Commun;eatians <br />Traf f ic --- <br />Pl�mliiir� — <br />_.. _ <br />; •..,,,.���<s � <br />---- <br />t:.l.. � C�•.�.��I luU�r.lon�ri . <br />• - .____ ..'_'_' <br />_ . n._..._ r.�� .� � 1 • 1 �i r'� . . _�_'_ _ _ .._'_ ' _"'_' __' ' _ ..__�. <br />