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APPLICATION FOR RIGHT-OF-WAK USE PERMIT 10276 <br />eveicn <br />� --, _. _ i <br />CITY ENGINEEflS pERMIT N0. �, = - �-' � � <br />EVERETT,WASHINGTON <br />TheUndersigned �A2�% k��'��Tr <br />Hereby app�ies for permission to <br />Lvnl�se��!>� ��i 2 0• Lci ��,v�n�,D E�ei rTiniC� <br />- , G1 L ni A�,1'i - - <br />At the following location <br />(Work to be done) <br />�aNnsc�a ��� � <br />r���a��n siui <br />TD PI� U IZ� RT Y <br />L I,Nt' <br />un scn� �' <br />DFIIVEWAY SECTION <br />NO SCALE <br />.1 <br />�3 � � _ <br />___—.— <br />�',i iPY OF TH�S APPLICATiON TO <br />'� E!.- POSTE� �)N JOBSITE. <br />jC,`.LI ENGI'.[ERIfJGDEPT.259�8811' <br />I?_t hiOU'��.:I L[f���HECONSTRUCTION <br />7� � ca✓e <br />ecto� Signaturc <br />j <br />i� <br />Ult1: <br />� �� �/ <br />Rer�� <br />c��,- ,eo�ke.-y � ,��,,,,.r,N�, <br />o� a f,�. � � �; �o �,�� . <br />UDI:7 <br />w— <br />£K,ISTIN!: <br />ISi�W[: CURU. r; Ui 1":_ R ra�YD <br />SI,�:�!I'ALK <br />�W�1• L7� LL��� �.�. <br />4•.iv-�, <br />�C'f!/�C F �0��O7C � <br />The undersigned owner hereby agrees to hold and <br />save harmless the City ot Everett (rom any and all <br />claims for damages that may arise because of installa� <br />tion and maintenance of the improvement hereto <br />applied (or and further agrees to remove same upon <br />no[ice from the City and to replace pyblic properry <br />�� S <br />� <br />Notc: Orii�inal to Customcr � 7[� <br />1 Capy in Filc �, �' ; _ , p � / ; p <br />_ . APProvedl�V�;'L�r.c.� • . c:.NYr�C;f� /'��`-!� <br />1 CoPy lu Insper.IN _�_%�_y,—_' <br />Datn Approvcd� <br />