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�� APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br /> e�erett ���� � <br />� e <br />� CITY ENGINEERS <br />� EVERETT, WASHINGTON PERMITNO. � 7 yY,�I__ <br />' The Undersigned_1�;'i� ��,-- .�/., / <br /> I <br /> Herebyappliesiorpermissionto_C�O/VS>ti�GT �� 1 / � /'�ci-�.� -y � - 5�� .� <br /> j <br /> �� At the following loca[ion " T-� /�:. � � �� � <br />'� SKETCH <br /> (Work to be done� . <br /> O <br /> ; �.l� N �� J >%�� /�:i ACNc'c> <br /> , <br /> ,r � � i � . <br /> � � <br /> . �: <br /> i� <br />! <br /> i <br /> , DRIVEwAY SECTION The undersigned owner herebv agrees to hold and <br />�I � NO SCALE_ _ save harmless the City of Everett from any and all <br /> ---"i claims for damages that may arise because of insta�la• <br /> i � . i^ L�p tion and maintenance of the improvement hereto <br /> appiied for and fur[her a r ts remove same upun <br /> 30' _ I 30" I no(ice�fr m-th9 Cit nd to re ac public properry <br /> � -- -- •.t• •.' dam g�ed�erAUY. -- <br /> �� Sign t of ApP�icant <br /> _ _ - /�/// /�✓c /�£,� 9Yy�/ <br /> I COPY OP THIS APPL'C/�"fION TO � Address <br /> � _ BE POST[D ON JOBSITE. �� / � <br /> CALL ENGIN[ERING DEPT. 259-8811 Telephone Nut�ba� <br /> �� � �_ <br />� � ?�t I!OURS F�FORF CONSTRUCTION Date g <br /> /O }� �> <br />� CHECK LIST Fr.e �'� <br /> Water Valve Dept. App�oValS <br /> Drainage <br />� Curb &Gutrer �7 "� - �� <br /> Engineers �"� i �C�� <br /> Sidewalk Water <br /> Street <br /> � � Communications <br /> Inspector's Signature Traffic <br />� �� Planning. <br />! <br />� ate <br /> i ` <br /> �� Rema�ks � <br /> Note: Original to Cus[omer — <br /> � 7 Copy to File `� �Q J Q <br /> �� i Copy to Inspector � Approved by <br />� Datc Approved <br />.� <br />