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APPLICATION FOR RIGHT-OF•WAY USE PERMIT <br /> evrren 1('Q 61 <br /> e <br /> CITY ENGINEERS �I <br /> ' EVERETT,WASHINGTON PERMIT N0. � � �.' 7 L �, <br /> The Undersigned_F'?Ul<.;�/i.r C- � "J/!/i" ��>7-S J n/C � <br /> Hereby applies for permission to /�o A/S TK�[ T R .'�O � .3 S%'�,`A-G. ; (�,�,ci , <br /> At the following location /D/ ✓ /l�l jl l�,C �s' ST � <br /> SKETCH <br /> (Work to be done) � <br /> S�E A-rr���,_�� I <br /> I ! <br /> i <br /> ; � <br /> i <br /> , , <br /> i <br /> I <br /> , <br /> � � <br /> �I I <br /> DRIVEWAY SECTtON The undersigned owner hereby agrees to hold and � j <br /> rl0 SCaLE save harmiess the Cib/ of Everett from any and all <br /> � I' -� claims for damages that may arise because of instaila� , I <br /> +I" LIP ��� tion and maintenance of the improvement hereto � <br /> I ;g appiied for and further aqrees to remove same upon �. , <br /> , �'�__—_—_- _—_�.30 '� <br /> notice from the City and to rep�ace pubiic property <br /> � damage�l thereb : ' . <br /> ;�v--9 ���—;�za-.,�-�:�>�..� . <br /> �-- --- ---- -� -� - �-----.__.._---� Addrees of�A ��a��( Hi2 J iQ c,�Q �.s,u✓�I <br /> 9 PP <br /> COPY Of- THIS nPPLICATION i0 � � <br /> ' BE POSTED ON J06SITE. I �-7 L �-� 7 � ��Q�j� � <br /> CALL GNGINEERING DEPT. 259�8811 I Telephone Number I, � <br /> [/z�/L�7 <br /> � �d I-IOUR� af_FORE CONSI_RUCTION� Date � ..Qo � � �� � <br /> �'� �� �,61�. <br /> CHECK LIST Fee <br /> Wacer vaive Dept. Approvals <br /> Drainage 9/ ; <br /> Curb & Gutter Engineers � �1:'✓�r'� � <br /> . Sidewalk Water ' <br /> Street <br /> Communications <br /> Inspector's Si9nawre <br /> Traf f ic <br /> Planning I <br /> at� � <br /> Remarks <br /> � Note: Original ro Customer I <br /> 1 Copy to Fi�e �,O 8 61 .. <br /> 1 Copy to Inspector Approved by , <br /> Date Approved <br /> ' <br /> ! <br /> � <br /> � - -� - — -- --- - - � <br />