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APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />���.�„ �0�8n <br />e ���� <br />yti <br />CITY ENG�NEERS ''� <br />F /ERETT, WASHINGTON PERMITNO. ��"U'CP <br />The Undersigned in/ ;/1 ; �,-.� �, � 1, ,_ � w no.l _ <br />Herebyappliesforpermissionto �nc1.1/ P�� o/u-.f ov� i C:f. R-O'� _ <br />At the following location �O / 2 W �� � F � �'✓ r' <br />SKETCH <br />(Work to be done) <br />DRIVEWAY SECTION <br />NO SCALE <br />� _ _ ___— �! - ___ ..�I <br />�� <br />j I" LIP� <br />L30�. ___ I 30" <br />i- —��� <br />— , <br />" OF THIS APPLICATION TG <br />"� � ;TED ON J06SITE. '� <br />�,I I. t7:�.�IP!ELRINfi nEPT.25�J-f361 t <br />���� ��� r. �•� �': �� :�IiF CQNSTRUCTIUr�: � <br />CHECK L�ST <br />Wamr Valve <br />Drainage <br />Curb & Gutter <br />Sidewalk <br />�,e �� <br />/•ji,T" r',,•�l'����,r �, <br />:;;�` , � /` �,� m. <br />Inspector's�Signature <br />��K���� . � P <br />Datr <br />Heniarks <br />Noie: Original tu Customcr <br />1 CoPY in Flc � <br />�� n ,�.. n <br />1 Cupy In Inspeclui <br />c.. :, <br />. . ,.i�.. r� M1 I <br />\i;i � <br />_._'- __ " y� <br />�� I <br />'.—_� '�' I <br />[, ;i� �� <br />I A'�t:.�...t�l! I'� � <br />1`IC JG�i�P <br />�/�h' fl. _�, <br />� - z , �. <br />1� �� 7 : <br />i <br />K'_I <br />Ij <br />��L <br />� <br />The undersigned o•-,aer hnreby agrees to hold and <br />save harmless the �..ty of Everett from any and all <br />claims for damage �� that may arise because of installa- <br />tion and maintenance of the improvement hereto <br />applied for and turthe� agre^s to remove same upon <br />notice from the City and to replace public property j <br />damaged thereby. `�' ��W�'� <br />� �- �t.ljT� �fi <br />ign ure of ApplicanY'� --� <br />so i,2 !'Ye s%- l� e �v Dr. <br />Address <br />�sz- sliz7 <br />Telephone Number <br />Date <br />De �t. Approvals // <br />� �---LG�-{�`-�� <br />Enginee <br />Water � �u Nj <br />Street '' % = <br />Communications . <br />Traftic �' � � /+�- <br />Plannirlg- � d <br />5�.., - �� Tl.�,� l. _ <br />nnn�o��d �y � � .�-� <br />Dnir ,appi eved <br />