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ev^relt <br />� <br />CITY ENGIN[ERS <br />EVERETf,WASHINGTON <br />APPLICATIQN FOF RIGHT-OF-WAY USE PERMIT ��� 1 O <br />TheUndcr�iyned �-��i�/�___{;�%L�S% /, <br />Hereby applies for permission to ( r;�� � T��.' �� �- -t- i <br />At the following Iccation_J_31 � l.L�. 1� C` <br />IUI...L �.. M .J....al <br />PERMIT N0. / � � �U� <br />1 <br />!>'7�1K1 L <br />DRIVEWAY SECTION <br />NO SCALE <br />�---- --- - --� <br />�_ I" LIP / <br />�;0„�- ._ _.- �30" I <br />� �1 <br />-_� <br />� i:OPY OF 1��i15 A.^PUCATION TO I <br />�'r,C FOS i ED ON JURSITE. <br />C;�LL ENGINEERING DEPT. 269�8611 I <br />' 2-0 HOURS BEFORE CONSTRUCTION' <br />�-----------�---' <br />CHECK LIST <br />Water Valve <br />Drainage <br />Curb & Gutter <br />Sidewalk <br />Inspector's Signamre � <br />Hcmarks � .. '1 <br />�_i.,.i.l �I <br />I^" <br />V\ <br />N <br />� <br />l3G l�!'%. .1 �> > � . � t��1 � <br />�, <br />The �ndersign' owner her�by agrees to hold and � <br />save harmless the City of Everett from any and all � <br />claims tor damages th;; may arise because of installa- �� <br />tion anC maintenance of the improvement hereto <br />applied for and further agrees to remove same upon � <br />notice from the Ciry and to Qlace u operry �� <br />d d t reby. J i <br />nature o pplicant <br />. 0�_ I /1 . /%%v,r/GT�rJ QAZ� � <br />Addrr,ss <br />�_�- /y4� <br />Tcle hone Number <br />�ULN�3�14>� <br />Datc <br />GI;:;TOC,i:3 <br />�Z � <br />Dept. Approvals <br />Communications <br />PI <br />— jt <br />i <br />Approved by � <br />Date Approve.d A '� <br />� <br />