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e�erctt APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br /> � �. v �U� <br /> CITY ENGINEERS <br /> EVERETT,WASHINGTON PEHMIT N0. I �� � I '. <br /> The Undersigned��if�G � . /� �/�/ 7'-' <br /> Hereby applies for permission to_ I7 �T Q S {) }.� D R� d��e1�4 Y <br /> At the tollowing location_ �� 3 �,p E.r/TUit/ PL <br /> SKETCH <br /> (Work to be donel <br /> i <br /> g 9 TN ST. 5, E <br /> — — — --- � <br /> 4_ <br /> U �nZ' �����_ ..�''.- <br /> ��/�VrM�=n T <br /> No ( • � <br /> ; Sc ,��c= � i . <br /> � i <br /> � i <br /> A ' ly�µ/ I <br /> oC <br /> m — — -- — �aPo —j <br /> 1 <br /> � <br /> ORIVEWAY SECTION The undersigned ownrn c�ieby agiees to hold and <br /> I �_ _ NO �CA�E � s3vc harmless the Gty of Everett from any and all <br /> 7 claims for damages that may ar,e because of installa� <br /> I" LIP �� tion and maintenance of the improvement hereto <br /> �30" _ ____ _ 30' J 3�� applied for and rurther agrees to remove same upon <br /> � � � �'2C-N7t�N ��„ notice from tl•e City and to replace public property <br /> dama ed theraby. , J , <br /> X ._c� <br /> ��l�� <br /> Signa ure r.(Appticant - <br /> - -- .` r'1; r,G',,,•.,, ra n/ <br /> � �'1 OF THIS APPLICATION TO Addres, <br /> "OSTEDONJ0651TE. , _' ;" ;` - -in l � <br /> . '� i Lt��;i^1GEI;ING LIEPT_ 259 381 i � Te'ephone Number <br /> � vniC> lS� L;�7� <br /> . • . �.i.�:;:; :?IJGR� cOf,1SiHUi:liu'J� Date � --7 <br /> CHECKLIST �`;` � � �� �s��-�p - 7v �k-3"��S�j <br /> Fee <br /> Water Valve Dept. Approval5 <br /> Drainage <br /> Cur6& Gutter Engineers .E„_�-',3'% <br /> Sidewalk � <br /> — Water <br /> P� Street �-r._��:�� <br /> K�>—�o ti Communications <br /> Inspector'sSignamre Traffic �� � � Za <br /> -� _-, Planning � ? <br /> � "7 <br /> � �5aie� . - . <br /> Remarks <br /> Note: Original to Customer <br /> : Copy to Fil,. � �l�?(� 7 <br /> �_. <br /> 1 CoPy tu Insper:toi � ApProved 6 <br /> Y <br /> Uatc Appioved ' � � �//-7 <br /> ,J/S / / � <br />