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everett � <br />� <br />CITY ENGINEERS <br />EVERETT,WASHINGTON <br />APPLICATION FOR RIGHT-OF-WAY USE PEFl�11T <br />10338 � <br />/���G <br />V / <br />_. .-i ! "` <br />PERMITNO._' T=' ^� -� <br />The Undersigned � � � "� '-��� �-��' • � r� "I'`� � � — <br />� „�.k r�/u / <br />Hereby applies for permission to «'V `�� ' "- �- � �-' <br />i <br />At the following location <br />�Work to be donel <br />� <br />f a • a ''c <br />v. a <br />�4_ b d . LO <br />� <br />� <br />GONS�T, GeiN� • <br />D r.�� ✓ C ��, <br />� <br />a, <br />,, 323 <br />� <br />� <br />..—n GLia'.-P"_ .C.� <br />LO� <br />I"L ' <br />Ih <br />l4 <br />1 �/., <br />1� <br />17 <br />,.i . a— i, / <br />���*7- ' , <br />' ._,�.�_ ' '. <br />� -_= <br />�-�' �� • �= .� - <br />DRIVEWAY SECTION <br />NO SCALE <br />r- �- --- --� <br />y,,� t.�P %� <br />i <br />�.30�„__ _ --.--.+30,� <br />COPY OF THIS APPLICATION TO �, <br />��. BE POSTED ON JOBSITE. I <br />� I G�I.L GNrINFE(iING DEPT. 259-SSi 1 <br />' �7��!Ii7UP5LiLFOR['.CONSTRUCTION <br />� CHECK LIST <br />' Water Valve <br />�. Drainage <br />Curb & Gutter <br />�� Sidewalk <br />Inspector's Signature <br />�t��t�!� <br />� ,,�, <br />., <br />iL �'i,`�:� <br />The undersigned owner hereby agrees to hold and <br />save harmless the City of Everett from any and all <br />claims for damages that may arise because of installa- <br />[ion and maintenance oi the improvement herero <br />applied for and further ac�rees to remove sama upon <br />notice from the City and to replace public property <br />damag thereby. <br />Signatu�pplican4�l✓�!�- -- <br />.�// c. d�c /LJ �/(%rt �iF, <br />Address <br />�.i�-�-[�// <br />Telephone Number <br />Date � <br />'�z.�u -��c G�. � If 1 _ <br />Fee <br />Dept. Approv s � <br />Engine / <br />Water a,��1�i�'�a+'� - <br />Street �'U� �� '/ <br />Communications ''� <br />_f.fc. �7-�>-7a� <br />Traffic_ �� � �'�- � � <br />Plannin9 � ) <br />Note: Original to Customer <br />7 CopY m File 1�' 3 3 8 Appi oved by �.Zj�' //7 <br />1 Copy to Inspector ___{1��--%ya �"'7� ' �' — <br />Date �pprold� <br />