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/. �=\ \� ^O/ /���� <br />',�, �� /:" ��1'I�C'.: L r� <br />, �. <br />' _. / <br />CVCII'li <br />� <br />ITY ENGIN[ERS <br />JERETT. WASIiINGTON <br />APPLICATION FOR RIGHT•OF-WAY US[ PERMIT <br />10937 <br />n �i'� , <br />< < � ' �' <br />PERMIT N0. <br />� <br />ie Undcrsigned _.,I^� �r n��? I�� /�/ f-A /? O -- -- <br />• <br />ereby applics tor permission to /' nN `' TI' Uc T � 2o G�AV -' L �yq/ -- <br />t[he following loca[ion 7� ��c.� l�/� UKr l.. T L°O L3L �/D yAi'� �� '� <br />York to be dane) <br />D.� fo <br />SB� f}7�IqGf1E) <br />�,,,r f-.�vo�- <br />�e ���� <br />G�/t�er"� %/�l� <br />ORIVEWAY SECTION <br />NO SCALE� <br />� LIP � <br />r3p•� � I .]O„ <br />COPY OF THIS APPLICATION TO <br />BE POSTED ON JO[3SITE. <br />CALL ENGINEERING DEPT. 25�J 8811 <br />24 HOURS �3EFORE CONSTRUCTION <br />CHECK LIST <br />WaNr Valve <br />Drainago <br />Cur6 & Guttcr <br />S�dewalk <br />Inspeclor's Si9naturc <br />�Date <br />Rrm,uk� '— <br />Nulr: On�Unal In Cuslninrr <br />1 Cnpy 1�+ I-dc ,_ l� J� l <br />The undersigned owner hereby agrees to hold and <br />save hartnless the City of Evere[t from any and all <br />claims tor damages that may arise because of installa• <br />tion and maintenance of the improvement hereto <br />applied for and furtlicr agrees to remove same upon <br />notice from City ard to replace pubiic property <br />damaged ' ch_ (/�� A <br />Signature f AppGcallt��� � <br />�/ �. U.�/�� � • <br />Address�.s.1v�l�(y _./� �•��75� <br />��� / (.(/ <br />Telephonc Number <br />3t'S' - ��'rG <br />Date <br />�8���� <br />Fee �Q % <br />Dept. /Approyals <br />Enginccrs�JL/�"� <br />Water <br />Communications <br />Tralfic <br />Plannin9 — <br />/1p�ttovrd I�y <br />