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0 <br />� cvcrctt <br />� <br />CITY fNGINGERS <br />FVERE7T, W�SHINGTON <br />APPLICATlON FOR flIGHT-OF•WAY I;SE PERMIT <br />11022. <br />PERMITN0.�1_ j">_� <br />TheUndersigned__1//h'G,:. �t:•n7T <br />Hereby aPPlies for permission to t�',on�Jr.'iJr.+ a_ �-� — <br />�—/�iS/'�'�,� ' 1=1>l'I �:' , .�.. <br />r ---- <br />AL thc fullowinp location_�f� �• --��_�^—� — '--' <br />' ���' f.iL/�_1l.f _.' _ _ <br />(1M1'ork to !w done) <br />SC� i9'1'i f?��/d D <br />d,� �D Ca77J7'"fac�� <br />e <br />DRIVEW4Y SECTIQN <br />NO SC4LE <br />� � <br />�f� LIP <br />30" ��...�... _ .____`_._.�.30 I <br />�� <br />COPY OF THIS APPLICATION TO <br />� BE POSTED ON JOBSITE. <br />CAIL ENGINEERING DEPT. 259-8811 <br />24 HOURS BEFORE CONSTRUCTION <br />� CHECK LIST <br />'� Watar Valve <br />Drainage <br />Curb & Gutter ' <br />Sidewalk <br />Inspoctor'c Sipn�turo <br />ate <br />Remarks <br />Nore: Oripinal to Cuttomer <br />1 Copy to File 110 2 2 <br />1 Copy ro Inspector <br />0 <br />i <br />. � � ..��� <br />9 <br />The undenipnec owner hereby pnes to hold and <br />cave harmie�i the City of Everott from any and all <br />claims !or dama9ee that may erise because of instal�a- <br />tion and maintenance of the improvement hereto <br />npplied for and further agrees to remove same upon <br />notice from the Ciryj}�d to repJ�e public properry <br />dam��d t reby. ///%/ //_�� <br />/ /" �/ !/ <br />� <br />w^����u / � ) <br />� 'S' ' ���(/ � . /(/ .. <br />Address '—�'—� ' � <br />_7_7_�=// 5�_ <br />Teleghone —• bcr <br />=� `�- _��� , � 7__�T % 7 <br />Datc <br />Fae <br />Dept. Approvals <br />� <br />Engineerc _��t � <br />Water <br />Strcet <br />Communications <br />Traffic <br />Planning <br />� <br />Aoc+�oved by <br />Dete Anoroved <br />