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APPLICATION FOR RIGHT-OF•WAY' USE PERMIT <br /> evcrc�t ' � r ' <br /> � _!. �1J�1. <br /> j <br /> CITY ENGINEERS <br /> [VERETT,WASHINGTON PERMIT N0. <br /> The Undersigned� �' �1� �"�! ���f��l ' �%`� � ' — -- — <br /> Hereby applies foi permission to Ci`N'=�iZd `� A �� N `��/•:NL t '�I'�v_'v/l�f� <br /> Atthefollowinglocation � l� l�/= n� /.���/-E ri-?i �E -- - <br /> SKETCH <br /> (Work to be done) <br /> .. _ .. .. _ _ .. __ _. . . . - __.. -- . . .. <br /> -- v�� �. � �-,,,r . , . <br /> ..- — �,� �„ ��I_ w � --�=h� . <br /> �i� � .� \��i _ . <br /> � �� � � <br /> II I d / U <br /> � I <br /> , ; `'\ <br /> i � <br /> ii . <br /> �I I� 7 7 1 P, <br /> � <br /> i ! <br /> „ <br /> —� . <br /> DRIVEWAv SECTION The undersigned owner hereby agrees to hold and .- <br /> rv0 SCn�E save harmless the Gty of Everett from any and all <br /> � I.,�— � claims for damages that may arise because of installa� <br /> � �7 tion and m,intenance of the improvement hereto <br /> L f� ��P--� I applied for and further agmes to remove szme upon <br /> I„30'+ . . �_ __—�30�� notice from the City and to replace public property <br /> -- - —d Tged thefebV.� �`'�-> ,� �� <br /> , <br /> 1.-�� i 1 t��' i --�-.•� - <br /> � ature of AQpI�r,�M .�. � <br /> ) (1 . �-;l � G" �='� <br /> ' ddress <br /> �"��'�� OFTHISAPPLICATIONTO � �1 , , �� �; - ;:'� (�J � �� <br /> �OSTED ON JOBSITE. � � — <br /> • Telephone Nurnbar 1 <br /> I c.:..',_!_ C��!Gltd[ERINGDEPT.259�8811 �. _i' ... � --- I � . _ <br /> I i��,i;�;s P,CI-ORCCONSTRUCTiU�'a Oate .��r _ . <br /> .�. <br /> �CHECK LIST Fee I� � � ,�� LZ�(- <br /> Water Valve Dept. QpI/pfOV IS � r,c� <br /> Draina9e R(/G... �.�e i.pc'e �- c cla f3,�f/: <br /> Curb&Gutter [ngindArs__ <br /> � <br /> Sidewalk Water � <br /> Street <br /> � <br /> •�_1 /,� ,,.�_� � Communica[ions '� � �'`� �*— <br /> �t='�`= <br /> Ins ectorsSignature Traf'�o___��j,,� <br /> �P�� •,- ��'N�li�r��"�ti�s , ,h," <br /> .� _ � — PlaiiTiRg� � . <br /> i <br /> �tc ' -- <br /> Rcinarks <br /> Notc: Origioal to Cusromer <br /> 1 CopY to File �,q 591 <br /> 1 CopV to Insn�cror Approved by <br /> Date AVPiuv��d <br />