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APPLICATION FOR RIGHT-OF-N'AY USE PERMIT <br /> everett �O n n O <br /> e �� <br /> CITY ENGINEERS 75 —/�7 <br /> EVERETT,WASHINGTON PERMIT NO. <br /> The Un�ec igned �EP. T CRON/N JP. � <br /> . Hereby applies tor permission to CON,STf2UC T /4 ' CQNC�PETF_ �/In/ ,(11J D/ T/O�Y . <br /> TO EX/ST/NG 21 ' CUNCRETE D/W <br /> At the tollowing location �¢�� RI�C K EF�L L.E�2 _ <br /> SKETCH <br /> (Wark to be done) <br /> I <br /> V <br /> --,�- � -- --- � ' <br /> C(1NCRETE ADDIT/bN T�1 D/W —�XI571NG CONCf'£TE U�6V <br /> �� �� l 4 '�~ STPEE 7— ! <br /> � <br /> � I <br /> ,, Q� , <br /> ! W <br /> I �1 t� tiur l4CJ2 I J <br /> I } �.�plhcc ! W <br /> i w ,�� �,���r.�so W ,�„ , <br /> � J � scwc.E <br /> , J V <br /> � Q <br /> j � � <br /> � <br /> i <br /> i DRIVEwAY SECTION The undersigned owner hereby agrees to hold and <br /> I NO SCALE save harmless the Ciry of Everett from any and all � <br /> �' r---- f[�( �— --- ---� claims for damages that may arise because oi installa� � <br /> I I'� LIP tion and maintenance of the improvement hereto � <br /> 3p' �—/! � 30' �pPlied for and further agrces to remove same upon <br /> I �—.}.— ---�t-/�----�.-.� notice irom the City and to repiace public property <br /> ( � ; dama ere y. � <br /> �J , � <br /> gnature Applicant <br /> _ P_ 0. Rox ,�7(07 ; <br /> COPY OF THIS APPLICATION TO Address I <br /> ' BE POSI ED ON JOBSITE. �. �53—�0-� �a '. <br /> CAIL ENGINEERING DEPT. 259�f?[;I i Telephone Number I <br /> ���r��' / - s��7 � ��S_ <br /> i : firll'RS f3EP07� C��fdSl-RIJf'l I�IiJ� � <br /> ^ CI �(�.� Date ��� �UE <br /> i CHECK LIST � Fee <br /> Water valve � � D�pt. Ap rovals �I <br /> Drainage <br /> Curb&Guttcr Engin� �jj i <br /> Sidewalk l � d� � q0� Water • � �� <br /> � �.n�„�z �— E=a�� /-�j,+�" � ' �'� ' c A �� � � <br /> /C UN ,o Street � <br /> /(�OJ�j�C(% �CJ SP C��C�� , ��`. �%NS�• Communications "�� "t` �� ��' 'J � <br /> InsPector'sSign� ure ;.. F. � � �+ +o 'fTra((ic i�' _. /. •. � '� � . �,' -��/' '' <br /> �cl�. I , . , . , ! I,.�;r�o�IPlanning _� � IV��'/ � '�. <br /> / –/_i –7J i <br /> ate �� <br /> emarks � ���� ����� ' <br /> Note: Original to Custor*.�r , <br /> 1 CopY to File 'L��q O / ' <br /> 1 Copy to Inspector Apprqv b ,/_ <br /> ,/�, �'��iy�✓��.�. (�— r%S <br /> Oatc Approved � <br />