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APPLICATION FOR RIGHT-OF-WAY USE PERMIT 10428 `i�l� , <br /> everetl `� <br /> e ,. ��2'I <br /> CITY ENGINEERS PERMIT N0. �� -�- �� <br /> EVERETT,WASHINGTON �. <br /> � ' � 10 �� n[ ��w <br /> The Undersigned 7� r V e � �" � �- c' � v � S — �, <br /> � r t s/� b` c�ns}��� ct �� 42 „ <br /> � ( ��fCF � �. <br /> Hereby applies for permission to _ _ <br /> � �P nC c G � ht c�< � 5�•�.� �SO� lon�.� � ' <br /> / i � D i !' llc� r F� vC� <br /> At the following location <br /> SKETCH <br /> � �Work to be done) ' <br /> I, <br /> S <br /> \ <br /> W <br /> I e <br /> A2.' t�ncc- I '�, � � � <br /> . VVI��1�I1 L �.M �./`�'� i � <br /> �� I a� Q <br /> dl � � <br /> '� I 9�O s/,,,. � ' = <br /> 2� -- '.� � <br /> --J '- � °i n ��-- <br /> T � 1� � � <br /> � - — <br /> � W4tQ( ' J Y <br /> ' .��a f��'.Y.-P�w ( d • � V <br /> Q � ! � � �i <br /> � <br /> I __'_ _'— I I <br /> '�. L'4'�..1 � <br /> 1 <br /> � IP�� , <br /> prnwn L f / <br /> Er..'�%�.3,/ H h/��- <br /> � <br /> DRIVEWAv SEC710N The undersigned owner hereby agrees to hoid and , <br /> � save harmless the City of Everett from any and a�l <br /> NO SCALE � claims for damages[hat may arise because of instalia� � <br /> ��� �------- tion and maintenance ot the improvement hereto . <br /> I" Lla applied for and further agrees to remove same upon I <br /> � _ I 3p I notice from the City and o replace public ��roPerry � <br /> 30" ' <br /> •t• —•' I <br /> I �-- -- damag d t Y. <br /> l �ACU� <br /> Sign ture of.Applican /� / ��1-�-1=-� � <br /> . , /'"� � / � �-��� � <br /> -- - Addre � r�(/ ', <br /> ICOPY OF THIS APPLICATION TO � , � � <br /> BE POSTED ON J0651TE. Telephone umber �. <br /> �. C�ILL EtJ!;INf_!:ftING D[PT. 259-St3711 9 �� �7[ <br /> Date <br /> . 7�1 IfOUfiS f3E(=ORG CONSTRUCTION� ��t� '. <br /> , W Fee <br /> CHECK LIST ��:�?�� i Dept. p� vals ' <br /> Watar Valve � �L . <br /> Drainage Engineers � � T <br /> Curb&Gutter �� Pe .��,_G,� , <br /> Sidewalk Water <br /> �s�' 5 t re e t_�L�=�i......� ' <br /> l' • C� Ccmmunications ` / / <br /> ' :?`.I. ' • 4 <br /> In tor'sSigna ur Traf(ic ;�- � " / �, <br /> _ Planning . / i �! �a.�/Y <br /> ('_ . /�" �J(Q $.�r�er (�� !; �hn er.1/f i <br /> -�t�—b,. l �PPro�ol to — <br /> ��;� -/b'� — <br /> R mark� g��7b <br /> � Notc: Oriyina� to Cusromer � n ^ n � _ v .�L� <br /> 7 CopV lo File ��4 G Approved by '� <br /> 7 Copy to Inspecror <br /> Date A prove <br />