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everett , . <br />e <br />CITY ENGINEERS <br />EVERETT. WASHINGTON <br />�� r <br />The Undersigned 1� �� _ <br />Hereby applies for permission to <br />�lI ��. . <br />APPLICATIQN FOR RIGHT-OF-WAY US� RMIT <br />r_� ==_H �) `,l ( �_ �l � =: <br />%y , -i <br />PERIJIIT N0. / ' %'` � , <br />��1� )`�1- - � <br />At the following location �� � C� � � <'!'��✓ �- ' ��"� � F � �r �-�` Z'� - <br />(Work to be done) <br />IV U <br />�cAt_r. <br />5 tJ o rt o'nn i s'-� <br />j�ISSI o?1 <br />NFvJ C3LAG�T�f'� <br />�_--.���y, <br />C:0'1r.1- _I <br />L�LD�- <br />Y-1�N�1� <br />(2E.TAl�-iG �nJ�L�S <br />----- -- -- - ---- — .. <br />j�LANitNCr STCI� <br />yz� � <br />i-�_-`__ _ <br />_ -, fa_-1� -.,.� <br />CY lS"r. SIpEWf��-�C � <br />� <br />� A :_.1 F= 1 C_ <br />DRIVENIIY SECTION <br />{� NO�SCALF <br />I �_� <br />�jl' LIP <br />3C.� <br />���-...----�—� -� � -- — <br />i COPY Of- TN'S APPLICAI�ION i�0 i, <br />itL= POSTED ON JOCSITE. I <br />CA�L ENGINEERING DEPT, 259�8811 � <br />24 HOUIiS 6EFOR[ CONSTRUCTIONI <br />CHECK LIST <br />Water Valve <br />Drainage <br />Curb & Gtrtter <br />Sidewalk <br />Inspec[or's Signature <br />Remarks <br />Note: Original ro Customer <br />1 Copy to File ' �� �� � <br />1 Copy to Inspecror � � <br />r', <br />The undersi�ned owner hereby agrees to hold and <br />save harmless the Ciry ot Everett from any and all <br />claims for damages that may arise because of installa� <br />tion and maintenance of the improvement hereto <br />applied for and further a9rer.s to remove same upon <br />notice from the City and to replace public property <br />damaged iherebyi -. �- � � �-� � � �'�� <br />�. i, <br />/. �<�. C�, ✓_. ., --- <br />Signature of Applicant <br />? rJ �" " F=-vCC-�/'�t_ �(..G`�.: <br />Address <br />1�9-Y5"vo <br />Telephone Numuer <br />�. _ 7. 3 .. /.;� — <br />Date <br />��.. � �. ��- <br />Fee <br />. �-� I/Deot. Aoorovals <br />Approved bv <br />Uate Approved <br />