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APPLICATIONFORRIGHT•OF•WAYUSEPERMIT 11�95 <br />Cllvl:Nr,INEERS <br />F.VGRE7T, 1VASHING70N PERMIT N0. <br />i <br />The Undersiyned � I FT�.��-' - U � � <br />Hcrehy applies (or permission to _ t)S F_ C-�[ I[T/N(�r — <br />At the following location_ (�F I Si h1 Uk l l_?� �LVD <br />SK[TCH <br />('.tibrk to bc done),'���� <br />�Jf.� L <br />�C/� b <br />�71,�1"-� <br />;; <br />�RiVEWAY SECTION <br />NO SCALE <br />f'—�----- �.1 <br />I <br />� { I" LIP <br />I� �� --�-��I <br />COPY OF 7HIS APPLICATION TO <br />BE P�STED CN JOBSITE. <br />CALL ENGW�FRING DEPT.259�8811 <br />2fHUUAS SEFORE CONSTRUCTION <br />CHECK LIST <br />VJater Valve <br />Drainaye <br />Curb & futter <br />Sidewalk <br />Intpector i Signaturc — <br />Remarks <br />11395 <br />/�� _. '�7 7 � �� <br />;� .. / <br />� <br />The undersigned owner hereby agrer.; to hold and <br />save hartn�ess the City o( [verett from any and all <br />elaims for damages Ihat may arise becau:e of ins�r:llr� <br />tion and maintenance ot the improvement hcreto <br />applicd for and fur[her a9recs to remove samc upon <br />notice irom lhe Ciry and to repiace public propr.rty <br />� aped [hereby. %� <br />- f�-,-..:� ./�/ G� E <br />S�gnaWre of AppLc�nt - <br />. �Qi?. �n� Si SNOi.�• �_l/•L�'i <br />Address '/ <br />� -7`�/� <br />Telephone Number <br />//J -/� - 7�J <br />Datc <br />Dept. Approvals <br />Communications <br />Planning <br />Approved by <br />CUSTOMER Datc Approved <br />