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APPLICATION FOR RIGHT-OF•WAY USE PERMIT <br />evcrett <br />�. <br />CITY ENGIiVEERS <br />EVERETT.WASHINGTON <br />The Undersigned ��// / J- It � L �. -U1� <br />,--,���� r;� �� , <br />Hereby applies for permission to _� <br />' At the tonowiny location_ l�l' I I !��li �� � L I C � /� i ��n <br />SKi. fCH <br />(Work to be done) <br />NO S�,-)L� <br />� <br />f�� '�''�'�i/ <br />C;�,� ; <br />;, <br />• U�� <br />�•=� <br />� <br />�_: <br />DRIVEWAY SECTICN <br />NO SCAL� <br />�------- �S --; <br />� �I" LIP � <br />30'�____ �Q--__�30 J <br />—i <br />� <br />1.0293 <br />PERMIT N0.__ ,��"'� <br />� <br />�_ <br />� �__ /� <br />% �` � <br />!� �SZjJ <br />� <br />��ur;t or- r_x isrtu,=� �;��i,�� <br />NB C J k' �_; ,;,` U� T;_ l�� <br />4:�': � <br />COPY OF ?HIS APPLICATION TO i <br />BE POSTED ON JOBSIiE. <br />CALL EIJGINEFRING DEPL 259�fli311 � I� �,,,'; ,� 1=: l� <br />LJ <br />:'4 HUURS f3GFOHE �.i)i�lSl'RUCTIUN � �' �-� L <br />- - � -_ �� - T_� <br />CFIECK L <br />� �'I ' r�� . � 1 <br />�te <br />The undersigned owner hereby agrees ro hold and <br />save harmless the City of Evcrett fror�� any and all <br />claims for damages that may arise because of installa� <br />tion and maintenance of the improvement herero <br />applied for and turther agrees to remove same upon <br />notice from the Ciry and to ieplace public propeiry <br />damaged hereby. , <br />v�..�., t .� rJ�,-L� . <br />Signature ot ApPlican� <br />/(,�. /J / 1�. � ,� �f '., �i ��-.{ . <br />Address <br />?�2- 1 L(�. <br />I Telephone Number <br />L � I � �1f' �ate � <br />�7. J 0 �i� i n G1(_ <br />Fee <br />1.�'..a/��� , � o .PTO� TD �A�a� <br />Remarks '��' f%�TI� l/.L�i1j'�J <br />,�� <br />Note: Original to Customer <br />7 CopY to File � C') C�'; <br />1 Copy to Inspector <br />Approved by / <br />� �.�c.f �� �'b <br />Date Approved <br />