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J�, . � � <br />l <br />i='" <br />�evcrcli� . <br />� <br />� <br />�_J <br />CIT'V ENGINEE�S <br />E V� R i. TT, 1'JASIi I N GTON <br />APPUCATION FOR RIGHT-OFWAY USG PERMI i <br />1`r:«�,� c - <br />, <br />10938 <br />7 i <br />PERM1IIT N0. � ' � `� % <br />TI�eUndeisignetl_ �.•�t�2 ; /r,aF'n <br />Hereby applies for perrnission ro�°:7��' r^ V�.'' � � p� �'/.'�i r HSi7 n�r K n/� / <br />i <br />At the following location 2� / 7� j I U �J. Tr o�_cS / �/� <br />&KETCH <br />(Work to lx donc� <br />Sc'E /�^;7r-1cfrE,� <br />'/�O �y�,�rU�1 / s �!.�ti �7�ui <br />ZfiA.i�r ,l>��'' Ge <br />Of"��-av�Je D,L - G�../ier�" �?'�•� ,de .��C-�� <br />DRIVEWAY SECTION <br />, NO SCALE� <br />� •--- <br />+I" LIP / � <br />i� J0 � � -!-'� <br />l � <br />COPY OF THIS APPLICATION TO <br />BE POSTED ON JOBSITE. <br />CALL ENGINEERING DEPT. 259•8877 <br />24 HOURS 6EFORE CONSTRUCTION <br />CHECK LIST � <br />Wator Valvc <br />Draina9c <br />Curb & Guttcr <br />Sidewalk <br />Inspecror's Si9nawre <br />�L'IIIdI llS <br />lo�c: Onipnal �u Gntnmrr <br />1 Copy 1�� I-d�• ��� �� ) J <br />1 Copy tu hrpnctur <br />The undersigned owner hereby agrecs to hold and <br />� save hartnless the City of Everett from any and all <br />elaims for dama9es that may arise because of installa• <br />tion and maintenance of the improvement hereto <br />applied for and further agrees to remove same upon <br />notice iw he Cit� to replace pubtic property <br />damage e�y. <br />ignature of Applicart/ 1 / <br />I��� fSt �G.ITCAlM <br />Address <br />—�-v�c�� Gf/.,�. �i'gi�s._ <br />Telepho • umber <br />�� f� 7 -3S'S-Yi4C <br />Date <br />fee �p �- <br />Dept. provals <br />En9ineers ./ � <br />Communications <br />Trolfic <br />Planning <br />Appiuved by <br />� <br />