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APPLICATION FOR RIGHT-OF-WAY USE PERMIT 1116 4 <br />evrrett , <br />.e <br />CITY ENGINEERS <br />EVERETT, WASHINGTON PERMIT N0. % P--!?i <br />The Undersigned / / ���-i> _ � � �Ji � �.. . � � . <br />Hereby applies for ermission to _L��Li,7-,� �% T p � c"r�� C ���4� � <br />_ �,�n� � } _ <br />At the following location_ /(. /1 ,c, � �• ( '� ��' i , ..r- <br />i <br />(Work to be done) <br />�c�'cnc <br />I(�'� S�rk rcT� ''`' <br />DHIVEWAY SECTION <br />� NO SCALE-- <br />—� <br />� j I" LIP <br />30'�'�___—'—_ .I 30" <br />---T <br />COPY OF THIS APPLICATION TO <br />BE ?OSTED ON JOBSITE, <br />CAIL ENGIiVEERING DEPT. 259�8871 <br />24 HOURS BEFORF CONSTRUCTION <br />CHECK LIST <br />Water Valve <br />Drainage <br />Curb & Gutter <br />Sidewalk <br />/ � , _�!',/ i <br />nspector.�Signat��-- <br />at��_ � ;� <br />� /� <br />Remarks <br />11164 <br />�--� -- � <br />i� <br />� <br />J <br />6 <br />� <br />_� <br />; <br />—1 <br />��MbvE EJ�iS7ri..iC, CvkB FRo�t1 <br />t�.C_. ol.) I(�iN -�-� So�Ti� t��c,PE�.rS` <br />�iIJE. <br />��i'�I�C� io �4`oT 'S �,-� 161J b � <br />DAuGt2a�s 5�0�� ��Aiit �s� <br />i lo rN 572E E T'. <br />-- ��� rz�cr �.u�4cE� c N41� �A��� a <br />I`JSPECTOR'S COPY <br />c ous� K�c T uE� sio�u�A�K l�ur> <br />Cu�.C3 iv sa��i.� r>,:�vF,zry <br />�. � uc- . _. <br />�oNsr�'vcT- �.�Eu� 2�� }�or <br />�IC iVE l-U (��� �{� 11JC ft C'()L' C��C- %� <br />�T '� � p C ��� ci t K. . <br />The undersigned owner hereby agre�s to hold and <br />save harmless the City of Everett from any and all <br />claims for damages that may arise because of installa� <br />tion and maintenance of the improvement hereto <br />applied for and furtlier agrees to remove same upon <br />notice from the Ciry and to replace public property <br />dam ed there y. <br />��r") � i�riCy.L <br />Signature,of Applicant -- <br />��V. hi..7! �S J�C ���1,�,..��LU 4�*7 c'Ni�}. <br />Address /� <br />����-�/l%q �o <br />Telep��n,ie� � � r <br />Date — <br />Dept. Approvals <br />Communications <br />.� <br />Approved by / { <br />%� ��, � � i . ' <br />— � ik'llC��,Y'� ' L9��'�/' <br />Datc Approved � ��1,/ y� �� O <br />�,-� -� .%l � � C 1 <br />r� <br />