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_ . .. _._ ._. .< <.¢ . <br /> � APPLICATION FQR RIGHT•OF-WAY USE PERMIT <br /> ' evcren <br /> � 1102� <br /> CITY IENGINEERS <br /> [VERETT, WASHINGTON PEfiM�TNO. ,� ~ ��Z�� <br /> The Und�i;iLned�-.�.�,�)uSAR t��1�1 �--- <br /> Htreby appGe:forpertnission to +'��ti^ri(!IC 7 rl 2 � � i�::1'l��y'Y �/W <br /> At the followinp loeation__�O£"' �iNlF h�__LL�'L.----- -- — f) '''�'.� "'.._ll�.(`f.} <br /> SKETCH ' <br /> (Work to be done) � <br /> SE�T �'riflGrfFD <br /> d� 7`"6 GarSy'�vL^fl <br /> �'� '�� " <br /> DRIVEWA� SECTiON The undenipned owner hereby prees to hold and <br /> NO SGLE sava harmluss tha City of Evcratt from any and oll <br /> �� —'— -'� claims lor d�xnages that may arise because of installa• <br /> ��• ��p tion and maintenance of the improvr.ment hereto <br /> _�_'__� <br /> I �0" I I��p„ I applicd for and further agrees to remove same upon <br /> t�-"'1'-' ��- —'-"--- -�'—T "�t notice f the Ciry a ,to replace public property <br /> da e her � � <br /> � natureof lic t `�� <br /> �=.2.�' �� G/' l �.��u. <br /> COPY OF THIS APPUCATION TO Address �r�,"��T"�" <br /> BE POSTED ON JOBSITE. ���5������ <br /> CALL ENGINEERING DEPT.259-8811 Telephon^Number <br /> ' � � V .� � � <br /> Y4 HOURS BEFORE CONSTRUCTION Date <br /> �� � <br /> CHECK LIST Fee <br /> water Va1ve Dept. Approvals <br /> Drainage <br /> Curb&Gutter Engineers <br /> Sidewalk " <br /> Water <br /> Street <br /> Communications <br /> Inspector't$ignature <br /> Tratiic <br /> Pla��ing — <br /> att _ <br /> Remarks <br /> Note: Original to Customer <br /> • , �oPY,oF��B 11027 <br /> 1 Copy to Inspectar ANproved by <br /> Date Approved <br />