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� - � APPLICATION FOR RIGH7•OF•YJAY USE PERMIT <br /> �:"" 10915 <br /> � <br /> .� . <br /> . . . . . ., . <br /> CITY ENGINEERS <br /> EVERETT,WASHINGTON . PERMIT N0. �� y3 <br /> The Undersiyned �[r�/A�D!✓n F�.E�/:HEii <br /> Hereby spplies for permission to (e�/ST u cT f} 2S� AS�';Yll/-�}� <br /> Atthe}o�%m .riglocation 7/YS �AiNlE�[ Dx��✓� <br /> SKEiCH <br /> ryVark to be done) <br /> • S/_`E t3 i�Ac rrer� <br /> U.� �'d G'�is7''/`v�- <br /> � ��...i�et�lc��,�e�J �-',�J� <br /> ����� �/� <br /> . ; <br /> . ; <br /> I <br /> . � <br /> DRIVEWAY SEC710N The urtdersigned owner hereby a�rees to hold and I <br /> NO SCALE save hartnless the City of Everett from any and all � <br /> �"'-- • --"I • tlaims for damages that may erise because of installa• � <br /> �•� ��P Uon and maintenance of the improvement hereto � <br /> 30"�— T 30' � apP��ed far and further agrees to remove same upon ( <br /> � + —� • notice irom the City and to replace oub�ir, property ( <br /> � nr�^thereb�� � <br /> i l tu o �ptica�it <br /> COPY OF THIS APPLICATION TO ddress <br /> BE POSTED ON JOBSITE. �� �c��.C� L)�fJ. 3J�G'���y <br /> CALL ENGINEERING DEPT. 259�8811 Teleph ne N mbe� <br /> 44 HOURS BEFORE CONSTRUCTION Oate �� /7 <br /> � � <br /> ��/2 S� <br /> CHECK LIST Fee • <br /> Water Valvc Dept. Ap roval5 <br /> Drainaqe n �/��J , <br /> Curb&Gutter . Enyineen � '� r�y' ._ <br /> Sidewalk Wattr <br /> Streei <br /> Communications <br /> Inspector's Signature Tratfic � <br /> Pl�nning <br /> ata <br /> Icmarks � <br /> lote: Original to Customer <br /> , �o,,Y �o F,�� 10 91 S <br /> 1 Copy �o h�sprctor Approved hy <br /> Datc AppwvcJ <br />