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�_ <br />everetl <br />i �e <br />i CITY ENGINEERS <br />I EVERETT, WASHINGTON <br />The Undersigned � <br />liereby applies for permissic <br />APPLICATION FOR RIGHT•UF•WAY USE PERMIT <br />11045 <br />PERMIT NO. � ��3 E 1 <br />' — /i�, i <br />to �:,.,�. T. .. ..I - a--..�r.� , -- <br />At the following Iceation 1`�ECrT�—�� �' � �''� � ! � �T + '�+� � <br />(Work to be done{ <br />ORIVEWAY SECTION <br />NO SCALE <br />� � <br />I�� LIP <br />30'+_ ---____�30.� <br />ICCPY OF THIS �1PPLICi\TION 1'0� ` <br />BE POSTED ON JO�SITE. I <br />I Cl�LL ENGIfJeERING DEPT.250�BR17 �, <br />i <br />� z�� Hour�s sEr-oe� cuns n��uc t�DN i <br />CNECK LIST <br />Water Valve <br />Drainage <br />Curb & Gutter <br />Sidewalk <br />Inspector's Signawre <br />Remarks <br />No[c: Original to Cusromer <br />1 Copy ro File 110 4 5 <br />1 Copy ro Inspector <br />,:,1. ,s i7 i % :'f i. /-�r li <br />TI e undersigned owner hereby agrees to hold and I <br />sare harmless the City ot Everett from any and all � <br />cluims for damages that may arise because of ins[alla- <br />tion and maiutenance of the improvement hereto � <br />applied for and further ay, ees to remove same upon , <br />notice trom the City and to replace public property � <br />dam ed thereby. � � <br />� � L L� <br />Sig ature o pplicant 1/ %� <br />�S�t�� /�s•u(�G7La-L, � <br />Addres <br />`�soa - / 9 �` !.%..,� .>;- t <br />Tc�ephone Num6er <br />3 3 � - -�.'ln� <br />Datc <br />i <br />/V-��6/-%'�' �r,' ii/�q�-,_ <br />Fec n� z���ri,..� _ �- ��� <br />Dept. Appro�als <br />Engineers �� " ��Lrf(�/-�`� <br />Communications _ <br />Tratiic <br />Plannina <br />Approved by <br />Dnte Approved <br />