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everetl <br /> APPLICATION FOR RIGHT•OF-WAY USE PeRMIT <br /> e 1036� <br /> ���/� <br /> Cli'Y ENGINEERS , .� , ! q_ -3/��'�'� <br /> EVERETI�,WASHINGTON PERMITNO. ��-� �r / <br /> � TheUndersigned �--� ��Va`���� f_.` �"� ---- = ! ! <br /> / �7- ' .� _ <br /> Hereby applies for permission to f,"�� i;---;T � ;� � . _ 'H � _ <br /> A[the following loca[ion =".7/ � — � � �""r/ S ,� <br /> SKETCH <br /> (Work to be done� �� <br /> 1 <br /> �, <br /> � <br /> v ��' <br /> f!i <br /> ` �Y I . <br /> i ��.�.� _ <br /> H i�. �) I �___ <br /> ��^� <br /> � ��{ � . � � �!t C�. <br /> \ <br /> ��� ��. �.} <br /> �� � �. <br /> , I <br /> Z o�.� <br /> , e � �.;• <br /> .� �.., . � <br /> � � � <br /> �li � \—�------ — <br /> � � l-,-,��r — •�.� - , _ - , , <br /> � <br /> I `. <br /> �. <br /> 'h <br /> \ <br /> � DRrvEwAv SF.CTION tt���` The undc�signcd owner hereby agrees to hold and <br /> NO SCALE � ��1 V.�i save liarmless the City of Everett from any and all <br /> � <br /> � .� � �� claims for dama9es that may arise because of installa� <br /> � !f� LIP �� '�� ^� tion and maintenance ol the improvement hemto <br /> �30" � 3p�� �` /y �PPlied loi anA lurther �grees to remove same upon <br /> -�--- ----'1'-- ��� � notice fr m Ihe City and to replace public pinporty <br /> � — � `1 da d therchy. � <br /> � 'ry�f �.�cs+�t_S t__�_�_<...�., / <br /> �!/1\\ SignaWre of APf� ani .y�� --�7'— <br /> ] � '��4—S�"i5+-�-*+�iJ � <br /> �� COPY OF 7HIS APPLICATION TO Ac�dress S�� <br /> , I L'E POS'P�D ON JO�SITE. � __��_s___/UZz. G� g <br /> Telephone Nmnber - ;'-7r '�� <br /> .'��.;_L FP1C,'INGERING DEPT. 7fi2-t3fi11 � ��,��- ��� <br /> � :'�Ili�il!(:� i?H'�111GCpf�"�Ili�ii:lliii�! Dat�j � - <br /> CHECK LIST ������--�—��� <br /> 1Jater Valve Fee <br /> Draina e U-�" p ro , Is <br /> e �t ;" � � .� �/�e <br /> Curb&Gutter Enginee r � <br /> Sidewalk Water _.L�� ,.-. .,�- � , <br /> S U eet.__l�✓C_�4 '������ <br /> __ _— Communicati li ,.. � <br /> Inspector's5ignaWre Traffic � ��7}�� � � �� J� <br /> Planning{ � � \.� r �( � 4 �� <br /> �ce - 5ec.,er. ��' 77. <br /> ;�'� � /3�.�„� <br /> Remarks <br /> Note: Oric�inal to Customer ._ <br /> , �a,�� ioF��� 10369 <br /> � 7 Copy to Inspecmr Approved b /� • <br /> �y�il 1. '��/�6� <br /> Datc Appioved � <br />