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APPLICA710N FOR RIGHT•OF-WAY USE PERMIT <br /> everen �O��O <br /> � <br /> CITY ENGINEERS <br /> EVEHETT,WASHWGTON � PERMITNO. �c- ' = `-2� <br /> The Undersigned )' .'�;�:e �-=%S,or � � <br /> , Hereby applies for permission to_Lpl„- ` �-���: t 7- ?S� A c p/� d/t L��v✓ �S �� <br /> � , <br /> Atthefoilowinglocation �;�� 7- �ai.,rc�.� Dr ��f l�/G-x � � <br /> ' �KETCH <br /> - (Work tr be done) � <br /> c-'f 7 <br /> I <br /> i <br /> i � <br /> I <br /> , <br /> ,, I o��V„� i{�-u <br /> I <br /> � <br /> � �\ ^ -.?o'/�s�n��f \ <br /> y ! � \ __ , <br /> \\ " \ r✓ye of N��Me.,t <br /> , �_ =�/' .�,- �, . a +„ <br /> � vi . . 4Y -.W- U_.! _Y_' <br /> - ` b�.—::-'6t � - ' � , <br /> iE- �S---,,+ 1 �' ,j' ,`, . <br /> . M N � : .� � � ' /3 I <br /> 1� �Jn �Qv }//ive. � <br /> � <br /> � <br /> IDRIVEWAY SECTION The undersigned owner hereby agrees to hold and -~�� � <br /> ' NO SCALE save harmless the Ciry of Everett from any and ail <br /> I� r-- -"i claims for damages that may arise because of installa- � <br /> f' LIP tion and maintenance of the improvement hereto � <br /> applied tor and further agrees [o:emove same upon <br /> � �30�+__. ______ ___�3o"�f _n�oticS-��nm ie Ciry and to r place lic properry <br /> ..+�—dam reby. � 'r . <br /> / <br /> Ir pp ica � <br /> � COPY OF THIS APPLICATION TO ' Address <br /> BE POSTED ON J06SITE. I <br /> � CALL ENGINE[RtNG DEP7.25�J-8fi11 � Telephone N mber <br /> i n �i -�[. <br /> �, � 21 I10UR5 !3[f-ORE CONSTRUCTION� Date , ' � �� ��. <br /> CHECK LIST Fce <br /> Waier vaive Dept. Approvals <br /> I Drainage <br /> '� Curb&Gut[er Engineers �-1 <br /> Sidewalk Water�Uo� �?iat NIc�=-RSe��L 1c�7�1� <br /> � Y <br /> Street .�` ' <br /> � � � <br /> Ccmmunications-. �%l^'-�-�`✓I�r.J<,:-�--� .liM✓�'.'� <br /> Inspector's Signature �' <br /> Traffic <br /> Planning � ^ �� Y� ,, <br /> �te jt�-.�.� V-� ia�n-� r•�� t T� . <br /> Remarks I <br /> Note: O�iginal to Custome� � <br /> , co�v �o Fu� �_(1�� p <br /> 1 Copy to Inspector Approved by <br /> Datc Approved ---- - -�- -- -- ��� <br />