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evcren <br />� <br />CITY ENGINEERS <br />EVERETT,WASHINGTON <br />The Undersigned / �� � � <br />Hereby xpplies for permitsion [o <br />At the tollowing location <br />(Work to be done) <br />. <br />APPLICATION FOR RIGHT-OF•WAY USE PERMIT <br />ndGf_$ J Ai4 Tve. dT <br />N�� �S py <br />DRIVEWAY SECTION <br />NO SCALE <br />r-- I 5 "--- --{ <br />+I" LIP � <br />� -�— � 30.� <br />30" _..��__-__—�._� <br />4 5'' _' <br />- DUIu. B Y' LQ t.l 1v1. <br />COPY OF THIS APPLIC�TIUfJ TO ' r� <br />BE POSTC-D ON JOBSITE. � y- �d `�S <br />CALL ENGINEERING DEPT. 259�BR11'I <br />24 I�IOUItS 13�f-ORE CONSTRUCTION <br />CHECK LIST <br />Water Valve <br />Draina9e <br />Cur6 & Gutter � <br />Sidewalk i <br />, ' , <br />'/i� / <br />Inspecmr's Signature <br />atc <br />Remarks <br />Note: Oriyinal to Customer <br />� <br />10283 <br />PERMITNO. ��—��� <br />/ �448 <br />D;'£ OF EX ST/N-� � <br />The undersigned owner hereby agrees to hold and <br />save harmless the City of Everett from any and all <br />claims for damages that may arise because of iastalla� <br />tion and maimenance ot the improvement herem <br />I' d f d i th t rem e same unon <br />app ie or an ur er agrees o ov , , <br />notice irom the City and to replace public property i <br />damaged therebX . � <br />f-I n��.�., S �-��w-.c� I <br />S gnature of Applicant �� <br />/��� /'YI�k;LTro g �..a. I <br />Address � <br />a� S o) - r% %: �c F' ✓� r� M <br />�tod o 3 <br />Telephone Number <br />�j• /S -75� <br />Date f- <br />T-_so -��F' f /1.7.1' <br />Fee <br />.7'G>•,'j---..p� 'i i> >�- <br />� <br />� J% 7/7 � � <br />�-�7/71� <br />, �a�Y ta F��� 10 ?_ 8 3 �p7yq r� <br />i CopV to Inspector APP� (,r'X C�. lizLfl���L��C/ � 2 Z-7J � <br />� — <br />Date Appr ved <br />� <br />