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--- - -� . . , <br /> evcrcn ANPLICqTION FOR RIGHT•OF"•WAY USE PERM,IT <br /> � � - 10934 <br /> CITY ENGIIJEERS <br /> EVERETI',WqSHINGTON PERMIT N0. �� 3'�� <br /> TheUndcrsigned�i�7/'�n�/ l-��ri�S <br /> Hereby applies tor permission to �nni�td'V� r q � � ' q p�p�� n�� ', <br /> At the following Ixation_/_L 1�-�-L.-yq q eT . " � <br /> SKETCH <br /> (Work to be done) <br /> SEf A7TACNr_D <br /> —�i.� �-o ��Sy7`c�`� <br /> �� ] <br /> . DRWEWl+Y SECiION . The undeisigned owner hereby agrees to hold and <br /> , NO SCALE save harmless the Ciry of Everett irom any and all <br /> �-- � claims tor damages that may arise because of installa- � <br /> i" Lta . . tion and maintenance of the improvemr.nt herero <br /> �JO�___�3p•� � applied for and further agrees to remove same upon <br /> -�i notice from the City and to repiace pubiic properry <br /> ' Aamaged thereby. <br /> c�,.=�_-�_.�"'G'�_��.,� <br /> Sig�nature of Applicant <br /> COPY OF THI$APPLICATION TO Add:��� � ?/ ? <br /> BE POSTED UN JOBSITE. �_��_�;�,;� <br /> CALL ENGWEERING DEPT. 259-AE11 Tele hone Num6cr �-"— <br /> 24 HOURS 6EFORE CONSTRUCTION �_ 9y�, <br /> Date �Z S,o <br /> CHECK UST Fee <br /> Water Valve <br /> Drainage Dept. Approvals <br /> Curb&Gutter Engineers�2���..c.� <br /> � Sidewalk _ <br /> `— Water <br /> Street <br /> Inspecior s5ignaWre Communications <br /> Traffic <br /> Planning <br /> —ISa�e-- <br /> Remarks <br /> Note' Oiiginai in Customer <br /> 1 Copy to File � � � 3 11 —_ <br /> 1 Cnpy to InsUcclo� - 1 <br /> AnProvrd by <br /> � <br /> r.,,,, n...,�,.,.�..� —�--- 1 <br />