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e. r.�91 <br />� <br />CITY ENGINEERS <br />EVERETT,WASHINGTON <br />The Undei,.�ned <br />F;ereby applies fE <br />APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />C� <br />�0058 <br />PERMIT NO. ��! — I / � <br />,�'S � CONcRFT� J�✓i.� <br />u I A �.A� � t�l G 1 T� 1 <br />_ R i G H-T c> � U.l A�j -r -. � r�s s�� a� a, 2 c��L s.� A� i� s� ,g,o.� � <br />At the following location 2�C% � � N n�T� N�✓/� _ <br />SKETCH <br />(Work [o be done) <br />r' <br />� <br />Z <br />� <br />J <br />4 <br />U <br />DRIVEWAV SECTION <br />�' NO SCA _ <br />�I- �; -�— — _-�17 <br />�� \ - {�I� LIP / � <br />�30�.__._ f_Z��___-__.—�}'30�1 <br />�� COPY OF ?HIS APPUCA:�ION TO I <br />E;E POSTED ON JO�SITL. <br />;;.1LL [NGINEERING DEPT. 259�f38i 1 I <br />:�1 Iii�URG l;fLf�l?RL CUf�i�TRUCI ION � j <br />No��Td� <br />3�+g, <br />O SGI�L�r <br />cZc���ACF_ GpNC, <br />::- 1DCi�UAt_K. - <br />%vE �, x <br />� `.: ">(.':, DIW J <br />•!AtJ�SCAJWG <br />AaEa To �s <br />PAVED <br />p�oG. <br />� <br />� . <br />�. ��: : . , <br />CHECK LIS"f � q <br />Water 9 alv� � ,� I.EG�D �.``� �� � <br />Draina e <br />Curb & Gutter (, <br />Sidewalk // / ��� I ��,y�ps <br />'�I� ector'sSignature (� /� '- <br />n(/��� ��)} <br />/f <br />�� ,���/'9� _ � L ` <br />��e v <br />, <br />Remarks <br />Note: Original to Customer <br />1 Copy w f-ilc <br />1 Cupy ta Inspector <br />R, �/j � /�o�� <br />C(15<' �I�B�Gr VO� <br />� <br />C�x.� /%'1 R"i��z <br />The undersigned owner hereby agrees to hold ard <br />save harmless the City of Everet[ from any and all <br />claims for damages that may arise because of installa� <br />tion and maintenance ot Ihe improvement hereto <br />, pplied for and further agrees to remove same upon <br />notice from the City and to replace public property <br />damaged thereby. <br />Signaiure o`�� — . <br />2 b�� I �L� c--�r' �' ,- <br />Address <br />��r�� �d�a - `� Z�z U f <br />Talephone Number <br />� �l � ; `� Approved by L� <br />Uatr, Approved � <br />��r/ g 7 f <br />