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APPLICATION FOR RIGHT•OF-WAY USE PERMI? <br /> - everetl 10 2 3 6 <br /> e � 7 <br /> CITY ENGINEERS /_� —' //� <br /> EVERETT,WASHINGTON PERMIT N0. <br /> The Undersigned ��fJ�[����� �n �'al��� � /� , <br /> Herehy applie�.for permi�i�sion to �/��ST/!��LS'T �� � �`��y���l'� `�����'J�,y �, <br /> � At the following lowtion�� � - , <br /> SKETCH � ' <br /> �� I � <br /> � (Work to be done) � <br /> � <br /> �-� � <br /> �� �DGt OF tl(Ifl"iNG P.9VE�(AF U i �•� /S� ! <br /> � i <br /> � I <br /> ; <br /> � i i <br /> , N �UI OOIJL'. �/!dl <br /> !, ' --- , �/ � I�1 , <br /> ; <br /> � ; � �o I . i i <br /> i � � <br /> i I� ; <br /> ; ;� <br /> �J i }�- <br /> I I IJ <br /> � , � <br /> i � <br /> I � � <br /> , <br /> i � �VO S('�1L'— <br /> � �X13TING Cr!(c'B f'.I�TF:R NN�9 � <br /> '� S I OE l.UAL I! ! I � rJ I <br /> ,' � <br /> � � <br /> � <br /> � i <br /> i ' � � <br /> ' DRivEWnv SECiiON I Thc widersigned owner hereby agrces to hold and �, <br /> '� NO SC E ' save harmless the City of Evere[t from any and all , <br /> � /�--- �—� claims tor damages that may arise because ot installa- � <br /> -'� tion and mainrenance of the improvement herero ! <br /> �N Lla � ��� applied for and turther agrees to remove samc upon I <br /> �30� �,_____ I 30"�,� � notice from the Ciry and to replace public property �. <br /> —�---- —'r� L11IJ N. Q�'� L.M. dam � there . <br /> 7/ ItJ i 75 ��-�����t <br /> Si nature��pli � ' <br /> ////)fY.fR'i�/�� ' <br /> ICOPY OF THIS .4PPIJCATION TO �' �ddress �� � <br /> BE POSTED OfV J06SITE. � d��� �>�� . <br /> Telep e Number <br /> I CALL fNGINEERING DEPT. 259�801 t �I ��__�� , <br /> ;4 HUURS [,f-.FORF COPJSTRUC11Uf�1�, Date �� � � <br /> � CHECK LIST �l�),'; '. Fee J <br /> ��� Water Valve / D0 [.�A��p, rOVa15 /-� . <br /> Drainage � . l ��Y�/«�C..rJC 7�( ."7,S <br /> � Curb&Gutter Engineers —.— <br /> Sidewalk Water �� �G �SY <br /> - 1 r . <br /> /�i j' Strcet�`�' � , <br /> .� r ` /�1� -�. , Communicati ns �� ��"- _ `� �'� — <br /> Inspector'sSignature Traffic - � i - .�i 7(/ �, <br /> -� .. ..` Planning� � � <br /> ,-i � - �� ,. � <br /> � <br /> Remarks <br /> Notc: Original to Customer <br /> 1 Copy to f-ile � �}��„,� 6 <br /> i Copq to Inspr.ctor ApProvc ,// ..-.` i��,I����v 7�7—�f. <br /> (-r.,L/ J <br /> �� Date Approved <br />