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APPLICATIONFORRIGHT-OF-WAYUSEPERMIT 11264 <br /> evercll <br /> 1 � <br /> CITYENGINEERS 7� ,7� <br /> EV ERETT. �vASHi NGTON PERMIT NO. <br /> � . �' � <br /> The Undarsigned � �jl'� /.. . � _ - I'I�/l�A2D Tp/� c �� <br /> . • , / I <br /> Here�y apN��Ps for permission ro '(� n/�/S �r�ic :�__rr J-.C� /a SP/�r1�1�/ , <br /> i <br /> At the folio�ving location� l7- / � � i I�1 !7 l JG I <br /> SKETCIi <br /> (�Vork to he done) . <br /> .� I <br /> ��. i �g.i` , <br /> i __, . . v._. _--------�___.__..__.____ � <br /> •` I -�•-'� ' .r ;1/ � . . ._ _ . _ . . � _. <br /> C -� � <br /> : � � � I � <br /> � ' . ��_�," I <br /> ��� � �. � � � <br /> � <br /> � i <br /> , , <br /> _� I � <br /> � � G''' /9S('%�Fii,i `..-------- - � /�'<"%' ' , <br /> .._ _'_"__` ___.......'_ . .__.._. ___.... C r � <br /> G/�, --�-3-- <br /> ..f� -�� - � r �:/! -- ;�. <br /> -� �- � � _) " "'_ I h`� J� I <br /> : i � �: � � /1 , �, �� <br /> � � , <br /> �. � ,(_'1 N „? ! / <br /> � I-- <br /> i . '".-.� " _"" '. . <br /> �� �.� <br /> I ,A� � <br /> '�. <br /> \ <br /> ll� i <br /> 1 � <br /> �'�oC1!1 hPw CVr �a 1 <br /> �1 � � <br /> �{�o�E fe� Vrll"`�a f��+ <br /> .. 1..1 .Go� la...(droo�:yt �. <br /> l � <br /> PY��' Ii fari t�r��••�• � �' <br /> DarvEwaY SECTiON The undersigned owner hereby agrees to hold and ' <br /> NO ScaLE save hanntess the City of Everett from any and all � <br /> �------- �� claims for damages tha[may arise because of installa- <br /> � +i" ��P _ tun and maintenance of the improvement hereto ' <br /> applied for and further agrees to remove same upon <br /> I 30'�_-�_ _ _,J�3o' I notice from the Cit and to re lace ublic ro er i <br /> 1�--- i � �1 Y P P P P tY , <br /> damag�there y. <br /> ____-__ __ _ _ ___- -.��-��"�" i <br /> �.. Signature of�ant <br /> I :.O?Y O� iHl ; :�PP�_�,C.ITION TO � Address� , . �.• ... `. . , � <br /> � �3c ?OSTcD CP: .:O[S�TE. .,• � r� . , _ , :- <br /> � Tetephone Number , <br /> �'� CAI_L ENGIP:E:RIMG pEPT. 259-891 i � ���� �- �i��.�.,� � <br /> �-i HUUR5 dEFORE CONSTRUCTIONI Date � <br /> �--------- <br /> CHECK LIST Fee"�� •�" ...{ %�,�' ����'_<i,, ����g,� ` <br /> ' WaturValve ' �� � y^ � <br /> Drainage Dept. Approvals ( <br /> � Curb&Gutter Engineers � <br /> Sidewalk Watcr ! <br /> Street I <br /> ! <br /> Cr,mmunications F <br /> Inspecror's Signature <br /> Treffic t <br /> Plmming � 1 <br /> I <br /> -6ate ---- € <br /> i <br /> Remarks � � G� ^ <br /> [} i <br /> -- k <br /> Approved by � <br /> � �11 , <br /> CU9TOMER Date Approvecl �. � <br /> ; i <br /> �A" <br />