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APPLICATION FOR RIGHT•OF-WAY USE PERMIT <br /> BVCfCII <br /> � 10258 <br /> CITY ENGiNEERS - � . <br /> EVERETT, WASHINGTON PERMITNO. /= M%�--•�� <br /> The Undersigned � / I i l-� �'�f� 1��� ��- �1,� i'� � 7 /p �/ <br /> Hereby applies for permission to �� _ I �� l��. C L l� � V� U,I\�� ��r �� ��Ul= IA����� <br /> At the following location Ji � ��� �� �i / U �\ l�i 1��. �' <br /> �. �� T �.� i� �� <br /> SKETCH <br /> (Work to be done) I � <br /> I I <br /> � <br /> � 3D13 � <br /> i <br /> � <br /> � <br /> � — �—_-- I ----- - <br /> �., ---_ — , <br /> � — _- _ _ _. -- <br /> _ ___._ _. . f i I.. 'N I f <br /> -c. � _ ___ .------ <br /> �.-� _. . f <br /> — — -- _.—_ . _._ / -.�� ._._._.�__ � <br /> 1\ h' _!'i./�i:E: ::r:)' >I` Blil11(;_.V <br /> '- '�` _�/Ii_!/�/a 1 K <br /> �`, �; w <br /> _ � <br /> f• � <br /> � i <br /> .- r"� � <br /> h� ' <br /> R <br /> r�� <br /> ti <br /> ,`~'. NU S(: �3L� <br /> T� <br /> DRIVEwaY SECiION � The undersigned owner hereby agrees to hold and <br /> NO SCALE save harmless the Ciry of Everett from any and all <br /> f'----- --" ----- - -� claims for damages that may arise because of installa� <br /> ���� �11�1� � ,!' ) � �� tion and maintenance of ihe improvement hereto <br /> � <br /> . �30_' I �---� � 30' I i ;- applied for and further agrees to remove same upon <br /> - T- ----�— - ��� - -+y 7- � -5 notice from the CitV and to replace public properry <br /> �ama�g� ed/trereby. /I <br /> . A/�„_ f� 1�/� i � r �.i�' <br /> S�pe u�re of Ap i a� � � <br /> jois i � � <br /> � coPv or- i�iis n����_��:�; � ir;r�, rn ndd��s� <br /> ee ro���r or� ior�:,ir�_ � �� � � 2 - / 7 `l � <br /> Telephone Number <br /> CilLLI:Ni;IfJLERINGDEPi". 26&P,FI ', � �— �� <br /> . '=t I�(�URS IiGf-OHE CONSTRUCTIpfJ� Date <br /> . 1'O /- - ;. <br /> CHECK LIST Fee -- <br /> Water Valve i �'�� � � ep . Ap roval5 t� <br /> Drainage / �� �y�,�,��GL r—�—�� <br /> Curb&Guttar Engineer <br /> Sidewalk <br /> Water �R�. ����S <br /> / Street��i��/ �' <br /> �'�;8a,.. Ccmmunicatio •�-� 1^--^.c-'(� - �-��� �. - <br /> I peeto�Signature Traf(ic }�.�- f'' � ':t� <br /> .� �� � Planning � �r � <br /> �ate <br /> � /,e <br /> �:?,,..�.z.�/�'�� /lE�-i� <br /> Remarks <br /> Note: Original to Customcr <br /> , �a�>y to F;�� 1. 0'S 8 <br /> 1 Copy to Inspr.r.�or `� AP17�m'e�V <br /> _��i � .Jrv C .i � i✓ - <br /> __, ___ __ '____. <br /> Datc Approved <br />