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'`. .� J I'/�-�..,- .-� �,� . • � .ra.ti <br /> n � .. ... � ' �<� � v ti � N .. <br /> G! � Pa- �-,-;;., <br /> . APPLICATION FOR RIGH"•OF-WAY USE PERMIT ' <br /> evcrett <br /> 1101� <br /> CITY ENGINEERS . '�' �� <br /> EVERETT, WASHINGTON PER�91T N0. ~ ��� �'�� =� __ <br /> � <br /> The Unaeisigned J �M _S�/�St P�n 12/ <br /> � <br /> HereLy appPas for permission to���N s."J � ,� s' s.`�'._y:�__�,i,;��;�'�.E�.... '� G' I <br /> At tlie toll„wing Iceation �7. � Y/, i.�l F�. t�3��(;�--`�f., ---.--- .--_. --.--- <br /> SKGTCH ----- ---- — <br /> IlYnrk ro be done) <br /> ��' •?' f�---.^�;i . <br /> h� <br /> rJ <br /> DRIVEWAY SECTIOk Thc undersi�inr.d owner hereby agrees to hold and <br /> NO SCALE save harmless ihe City ot Evcret[irom any and all <br /> � - � �� � - � claims tor darnapes that may aiise becausc of installa� <br /> �_-�_�•' �ip—�� tion and maintenance of the impruvement hereto <br /> �30';�_ T . �g0" i aPPlicd for and fur�her a9recs to removc same upon <br /> � � -�� -� � � notice 0-om the C�ty and to replace public properry <br /> dzmaged thcreby. �,•'} <br /> . i.f 1(1�-'i/t�l_''.t'LC=_L'�t��1���1�G.G.1 <br /> Sipna[urr. of Applicant � <br /> COPY OF THIS APPLICAI�ION TO Address <br /> BE POSTED ON J0351TE. <br /> �CALL ENGINEERING DEPT. 259�8811 Tclephone Number <br /> 24 HOURS OF.FORE CONSTRUCTION Date <br /> CHECK UST p��"�i r'"'--- <br /> Wator Valve <br /> Ura inage Dept,App�vals <br /> Curh w Gutter Enpinecrs�+_y�i_,�;.'�1„"_ <br /> Sidewalk Water <br /> Strect_______,___ _ <br /> __._____._ f,ommunications_ <br /> Inspector's Signature Traffic <br /> Planning <br /> �te�� —�— -- _ - <br /> Remarks <br /> Note: Original to Customer - — <br /> , �oPY to F��� 11016 <br /> 1 Copy to Inspector Appraved by <br />