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cveretl <br />�i <br />CITY ENGINEERS <br />EVERETT,WASHINGTON <br />The Undersigned ! ) L <br />Here6y appliez tor permission to <br />APPLICATfON FOR RIGHT-OF-WAY USE PERMIT <br />1> S�� I r" �%c' � tr.�' ,i/ <br />1 A V d�-, L7lJ A I i r�7A/ l�_ <br />10251 <br />PERMITNO. �� � � �= f� <br />At the following location -T � �'� � l�'�_. �l � �� - 1 UG • <br />�or� -ss :��r. �,; �-; -+-� <br />SKETCH <br />(Work to be done) �tti ��� <br />`t / <br />5N, �l- D�= d �=1 ic c;1 i J <br />�' �` �.ii L ���/E D <br />� X(`_,T�Aii= (. <br />NO SG�,��. <br />DRIVEWAY <br />NO SCALE �J <br />�—_' I <br />�—� `�--�1 <br />�.ao-i._ . _�\_ __-�.3o'J <br />�.';Ui'Y�rFlH15%�i-PLILi�llOfd IU <br />ISF POSTGD OIJ Jq[3[ITF. <br />�:l.LL ENGIN[ERING DEPT. 259�8811 il <br />7� il�ji iR��, rl' �-UHC r'q'.lel (iiJCTION� <br />CHECK LIST /� <br />Water Valve i ?1" ��O / 1'J <br />Drainage � <br />Curb & Gutter ,.c�R��Y <br />Sidewalk <br />i '��( c — <br />Inspector's Siynature <br />_ i - <br />f/ <br />L <br />i � �r ; <br />i ;'�,r �'�,,,1_�.�,. tJ0 CUIZ[3 �1(J�l"it� <br />-� �'`�� .t . <br />' • <br />41,^ �U <br />ji'>., � <br />9f��� `; + <br />I___ ��. � �= <br />�-.1 <br />n,. . <br />;r�?,:' 1 <br />oiuu.��+ ��� <br />�g—l— 75 <br />� � ✓Q. OV f 1' <br />Me {� ,- �o � <br />� <br />I ; � . <br />� <br />� <br />I <br />�ie undersigned owner hereby agrees to hold and <br />save liarmless the City of Everett from any and all <br />claims tor damages that may arisr, because of installa- <br />[ion and maintenance of the improvement herr,to <br />applied for and further ac�rees t emove same uPon <br />notice from}he City and t¢r place pu8lic property <br />r _, 7 ��� __ <br />Date <br />Ni� /==r -- <br />Fee <br />ept Ap/provals <br />Engineers �1--y7�^,"c"L�'✓ C�'� -%J <br />�SNater � ' ' <br />Street��;_��y� <br />Communicatip s—'� �� � a�� - �-'' - "� <br />Traffic� ; - <br />Planning � 1 7�— _ <br />Note: Original to Customer <br />1 CopV to File 10?_ 51 <br />1 Copy to Inspec[or Approvedby i � / �7 <br />�/_ � l .�%'±�_L� L J Lly. � ,C� <br />Date�Ap� <br />