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--� APPLICATION FOR RIGHT-OF-WAY USE PERMIT ��'�3 g <br /> ��•vcrcli 1 � <br /> � .�' �-��,� _ J c. <br /> CITY ENGINEERS <br /> FVERE iT. N'ASHI�'GTON PERMIT NO.� "�, <br /> TheUndeisigned ' �. �� ��,(��! ��—/'J � <br /> Herebyapp�icsforpermissionto_��j,�11i,t�4'rl'- -�-5 � �a .c1[ �jiU1= t�.'Ac9 — <br /> At the following location�� �r��� ��1 Z—����� �—`�'�� <br /> SKETCH <br /> (Work to bc done) <br /> ��(-� <br /> a�'�a <br /> ���wAL� <br /> �f <br /> � �,� <br /> (� <br /> �1•'I� � a' �— <br /> �� <br /> � ,�• �� ' �, . <br /> � <br /> DRrv[wav SECTiON The undersigned ownen c�reby agreez to hoid and <br /> � rv0 SCaLE :a+e harm!ess tht City of Everett from any and all <br /> L--- --� ciaims fm damages that may arise because of installa• <br /> � tion and maintonance of the improvement hereto <br /> ��� ��P � applied for and fur[her agrees to remove same upon <br /> �30'�,_ _ ___—._--._.—.�}.3�+� notice tro the City and to replace public property <br /> damaged reby. � <br /> Sign� �,- � I���� �� <br /> �oS Applicant I <br /> � ,b��"y �-� /3./ �'�l — <br /> COi'Y 0` iN15 APPLICATION TO I AdJress <br /> 6E PUSTE�ON J08SITE I ��"�E � <br /> Tclephone Number <br /> CALL FiJGINcERING DEPT. 25'J�S971 I �j_��=7[f <br /> 24 HOURS (3EFORE CO�STRUCTIONi Datc <br /> CHGCK LIST Fee <br /> Watar Valve Dept. ��pproval5 <br /> Draina9e <br /> Curh&Gu[ter C-ngineers <br /> $idewalk Water__ <br /> Street _ <br /> Commwiications <br /> Inspector's Signature Traffic _ <br /> Plannin9_ <br /> I�te <br /> Rcrnar�s � � G �O — --- <br /> Appioveti6y �- � -� �----'� — <br /> CU�TO:d�:R Dale ApProved p <br />