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APPLICATION FOR RIGHT-OF-WAY USE PERNIIT
<br /> everetl
<br /> 10439
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<br /> CITY ENGINEERS `� -~"��
<br /> EVERETT, WASHINGTON PERMIT N0. 7c-- �J
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<br /> The Undersigned_�y�� - /��i.r �-,�. _ /
<br /> Herebyappliesforpermissionto_�`�w�� . � �.kc.I �;�� /-r�- �-�� .• .�i�<.c( "1G-(4l-��.rF� .- � ,
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<br /> � At the fotlowing location ' �f % - '✓� ,� %ry' . _ ,
<br /> SKETCH F�i
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<br /> DRNEwAY SECTION f:r,,,-_("��` ;y �/j��. The undersigned owner hereby agre_s to hold and '�,
<br /> NO SCALE ' save harmless t�c Ciry of Everett from any and all ��
<br /> � �— 2.-'� � -- �-"{ claims for damages that inay arise because of installa� �',
<br /> `I'� LIP tion and maintenance of the improvement hereto ��
<br /> �- ' applied for anc further a9rces tu remove same upon
<br /> �U'�-______+30" I notice from tha City and to replace public property �
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<br /> damaged thereby. � i
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<br /> 'y�l ��,,� Sigriature ot�pplic �(
<br /> j2/I v✓cU � ( � F .t.- � /I / . ��
<br /> COPY OF THIS APPLICATION TO � Address �
<br /> BE POSTED ON JOBSITE. y�, >'- ` i I R' � ��
<br /> Telep on�i'e Numbei �
<br /> � CALL ENGINE[AING DEPT. 25�J�BR11 II �s (i ��-1 �E ,
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<br /> � 2t HOU133 (?EI'OHE COfJSTHliC71CHj Date 7 / /--/�'�..,.
<br /> . .. . . _ . � /�� J(� P/.! . .�?J�1�,Ej �
<br /> ' CHECK UST Fee / '/ �
<br /> Wacer vaive De t. ppro Is i ,
<br /> Drainaye / �-/ ` �i
<br /> Curb&Gutter Engineers / �
<br /> Sidewa�k Water - � Dei- e e��sa5� ,f1.G, L�• i
<br /> � s«ee� _ '_��._.:,�--- i
<br /> L�C'ii../ Ccmmunications_L� _ , I
<br /> Ins or's Signa ure / � 9�{ �
<br /> i Traffic y�
<br /> in� _ �� . ) � Plannin - "y._..�'/ � � ��,�C.,,��
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<br /> ate - - - Sec.�et, /l�,�7�i,,��vso<, N'��G�Td.s ` i
<br /> Remarks — � ,
<br /> Note: Oi iginal to Customer -
<br /> , �ouY �o F,�� 1�A�9 ���
<br /> 1 CoPY �o InsPr.cror Anp�ovrd bY ��%��,tl������ ��
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<br /> Date Appi ed
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