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everett <br />: � <br />CITY ENGINEERS <br />EVERETT, WASHING�ON <br />APPLICATION FOR RIGHT•OF-WAY USE F'ERMIT p <br />�� .- ---- _ % 1��06 <br />PERMITNO. ��/��a� <br />The Undersigned i ����) ✓�-i�" T'��1 K%��/ _ <br />Hereby applies for permission to � n �/ �.;, � .� .� i ; � " ; :i ,.,r . � i,,, .:.,; ,�: -,=., i n � r : � .? - � i_;:--� - � — <br />-�!�_i. ,� -Jr' '.i�1�1. C /°�IJr:' _ r=.i /JA .L��.i 1V< <br />-r <br />At the following locauun �•�, , r.+ <„ - ,r� � : � i ,. ,, „ � i 7O " <,-+tT cs>..,,.-,,,i .,, . � v � - ... r 7. <br />(Work to be dane� <br />SE _ ijT. .,=,CN=" n• <br />DRIVEWAY SECTION <br />NO SCALE <br />�-- ---- �-� <br />�. �I" LIP � <br />�4.�..__ _ -_-___-.{.3� <br />�� ----- - -- - - --- ---._ . <br />CJPY rJf 11d15 GPPLICAiION "10 � <br />I 3E POSTED ON JJ851TE. <br />� CALL ENGIN�ERING DEPT. 759-II811 <br />I- Jd IIOUliS 3r-.. ,�, �Z[ r:p;�15THUCTII)N �I <br />__ . . � .. . _ . <br />l CHECK LIST <br />�Water Valve <br />Draina�e <br />Curb & Gutter <br />Sidewalk <br />Inspector's Signature <br />flemarks <br />Note: Original to Customer <br />1 Copy to File 11 U�? 6 <br />1 Copy to Inspector <br />� ���C% ��'! !! l.� � ; T-� � .%�, i _/,; <br />The undersigned owner hereby agrees to hold and <br />save harmless the Ciry of Everett irom any and al� <br />claims tor damages that may arise because u( ins[alla� <br />tion and aintenance ot the improvement hereto <br />appligd i r and iwther a9rees to reT ove ame upon <br />notfc�fr m the Ciry and to repFpgl` pu� property <br />.,��.�,. ��� t � �S <br />Telephone Ncmber <br />/`! 9 / 1� <br />Date �� <br />hee „/., r�C � <br />Dept. ppru�als <br />�� ii <br />Engineers �.�' �4 -/ <br />Water <br />Communications <br />PI <br />Approved 6y <br />Datc Approved <br />