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APPLICATIOfU FOR RIGHT-OF-WAY USE PERMIT <br /> everclt 110 7 9 <br /> � I <br /> CITYENGINEERS �7/� 7� � <br /> EVERETT,WASHINGTON PERMIT NO. ' <br /> TheUnderrigned r1'� '.4 i� - ��'+ - - - <br /> Hereby applies for permission to � 't"�v�T'�i� " � Z � " - - i��i �' <br /> At the following location Ci/� iN'P' ' �''�n� ' c�� II <br /> .) r <br /> SKETCH l jrr� i�-' � <br /> (Work to be done) ��� � � ���%� '. � / , , � <br /> r l <br /> � <br /> �/' �'� '�j SE� �'r�ACH%,�> <br /> - ���.., � ', <br /> F� <br /> Y i <br /> � <br /> DRlvEWAv SECTiON The undersigned owner hereby agrees to hold and � <br /> NO SfALE save harmless the City of Everett trom any and all �. <br /> ff-- — � claims for damages that may arise because of installa� . <br /> j I" LIF �� tion and maintenance ot the improvement hereto , <br /> � 30' applied for and further agrees to re ove same upon <br /> �3v y . _.___.. - ._.- ..a... '� notice froi �he Ciry d r �la public properry <br /> da e8 �rcby. <br /> �� � 1Q/ <br /> ./-S a ure of pn i•�r � <br /> 1 <br /> ��^ ' ' <br /> � COI'Y �'.f Iili5 :U"'LIGl,i �� ���! I� � re�s � nr� u�� n: <br /> �s� r�osreu orv �u�s�n�. �75=-�— 3 0 3 <br /> � Telep pr�e Number � <br /> CALIFNGINEfRINGDGPT. 259�8i1t1 ' N�,u �r�.�T���� <br /> 74 rl(�lr;c .':'FOH[ t:C��f15liii�Cl������ Date' <br /> . � '7�. n�/(�91 <br /> CHECK LIST Fee �� >_"�-T'^1T'�T- <br /> Water Valve Dept. Approval5 � <br /> Drainage �� � <br /> Curb&Gutter Engineers , � ��,-.- - - _ <br /> Sidewalk Water � <br /> SVeet_ _ I <br /> Communications I� <br /> Inspector's Signaturc Tra(tic <br /> Planning <br /> at-�— <br /> Remarks <br /> Note: Original to Customcr <br /> 7CopytoFile 11�79 ,, <br /> 1 Ccpy ta Inspec�or Approved by <br /> Date Approved <br />