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I APPLICATION FOR RIGHT•OF-WAY USE PERMIT <br /> evcretl q O r�r�� <br /> � 1 GG <br />� CITY ENGINEERS � %-� ') <br />, EVERETT,WASHINGTON PERM1IIT NO. i� � ���� / <br /> The Undersigned I � I�\l�^/ V �7I- I�/ !l V V /"I I �-7 V �V <br /> ' Hereby applies for permission to �� �J �V `J I �l�� � � � � [�� �� � �� <br />� . At the following location �(J��� /Y� V L/ !� ��_ i i � � � Q � �� . <br /> SKETCH <br /> � (Work to be done) ��� � <br /> ' �-- EX15 TING G " Ci?�UC. <br /> I CURB. <br /> � ., , ' <br /> �—,J <br /> �C7/ <br /> I <br /> �I---- <br /> f tAT <br /> I !VY <br />' L c� I i � <br /> ; �-Q�T t O � � � <br /> 6030 <br /> i - CONS T KUCT� 2 C�,�,�. <br /> STF /�S T� �L1/� TCN <br /> � IN� �f R�ST� RE CUI D��l <br /> ----- S£C T I U,U <br /> �-_----- - <br /> � <br /> �ND SC /�L�� <br /> � � <br /> ,,. , ..;.__ --_--- - . _ � <br /> k. <br /> � <br />� � . <br /> � <br /> DRIVEWAY SECTION � The undersigned owner hereby agrees to hold and � <br /> NO SCALE ���/ save harmle:s the Ciry of Everett from any and all �, <br /> r --—� claims for damages that may anse because of installa� ' <br /> i„ tion and maintenance of the improvement hereto I <br /> � applied for and (urther agr^_es to remove same upon ��, <br /> I 3��__ �30'� notic from the Ciry and to replace public property ! <br /> ar.uN. ati L.M � , <br /> d�rfia ed thereby. <br /> 6/30/ 7S � _ _ . � �' � <br /> S/ignature of A�plicant �/ / � <br /> }^o'.=�C //"�z..i.r-..ri /.f.a�C.� I <br /> COPY Of- THIS APPLICATION TO � Addre� p '. <br /> BE POSTED ON J08SITE. I `3��- T� 'J / '. <br /> Telephone Number ' <br /> ' CALL [MGINEERING DEPT. 259�8811 � �� �1 �� >;j � � <br /> . s / { <br /> � 24 FIOIIRS GEFORE C7NSTRUCTIG� Da[e = <br /> �— - - c��; S :1 1��c ���� <br /> � CHCCK LIST Fee . <br /> Water Valve < Dept. Approvals <br /> Drainage � � -�� �� ', <br /> Curb&Gutter Engineers � S/ - 1U , <br /> Sidewalk Water�� �- 7/2L��j� � <br /> � , I <br /> �f''�� .' + /�/ Sveet � �� � � . <br /> % " � �,�i_`-' Communications � � �� ' 7'/-7a I <br /> Inspector'sSi�nature Traific ' � �— � � 7 <br /> / ._ (�.0 , ( 1 Planninc�l" ./ „�, 7-/- 7S I <br /> J <br /> at�e — <br /> �� ��j � (`� <br /> ( �i / . �. � --� � i � <br /> Remarks <br /> Note: Original to Customer �� <br /> 1 Copy to Fiie � , <br /> 1 Copy to Inspector �O��� Approved by .' � j i � � � � <br /> . - �' ) c- ) �-'f.:'/q i , �,'t'i,i h!7 tG(� � <br /> 7--rTf" . <br /> Date Approved �� <br /> � <br /> � <br />