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everett APPLICATION FOR RIGHT-OF-WAY USE PERMIT � � 2 2 O <br /> , � - <br /> CITY ENGI."JEERS <br /> EVERETT,WASFiINGTON PERMITNO. � �� <br /> The Undersigned � � - <br /> Hereby applies tor permission to ' ' i �� � - <br /> i <br /> ' At the following location G �' � - � � � ' <br /> SKETCH <br /> (Work to be done) <br /> i <br /> ci � �-.,' ." ; � �_ <br /> _- <br /> . — � "a. "i'�,.,,. , ,� ' .-: ' � <br /> ------ --- J1,5 d <br /> I __ ._-----� z -- <br /> � � z�� ~ f�,.�� .�� _, <br /> 'E.sv,.�7;/�., <br /> � � / <br /> . <br /> � j / <br /> �'�' Dv , � <br /> �: I I �` N i .�E <br /> , � <br /> � <br /> i � za' 20 \. <br /> � ����� [wC l� Q 1 `,,.: <br /> � � , <br /> IT �,;.,� �,�. a },�� . <br /> ., �.�f- � , <br /> ,��.� I � <br /> - - .. . ,. <br /> � � <br /> \ <br /> i <br /> �, ' �,�(,,,,^ :,v1� c�-a��� <br /> � � ✓� <br /> DRivEwav SEC710N The undersigned owner hereby a �e�toliold�d <br /> {� NO SCaLE � save harmless the City of Everett from any and all <br /> i • ' - - - �---"I claims for damages that may arise because of installa- <br /> i^ i�p tion and maintenance of Ihe improvement hereto <br /> �-�30'+ ` _ 30' applied for and further agrees to removr.same upon <br /> -1 . - .`�'--.J notice from ihe Ciry and to replace public property <br /> damaged thereby,. <br /> ._..:,�_i '� �_. <br /> Signature of ApplicaAt (/ <br /> ,. �l� /9 V f3 j <br /> COPY OF THIS APPLICATION TO Address ,r%/�' /ans7� <br /> BE POSTED ON JOBSITE. �'-� ��- �° ��' i 9 4�Si '�,7, <br /> Telephone Number <br /> CALL ENGINEERING DEPT. 259�8811 �.? „ � �. � Q <br /> 24 HOURS f3EFORE CONSTRUCTION Date � — <br /> CHECK IIST Fne � <br /> Water Va�ve De�t. Approvals <br /> Drainage <br /> Cur6&Gutter � Engineers_ <br /> Sidewalk <br /> Water____ <br /> � Sireet <br /> Communications <br /> Inspector- Si n ure Traf(ic <br /> � <br /> � _ �� �- � � Planning <br /> at�e- <br /> Remarks <br /> � ti � � ;, <br /> Approvedby �.�"' ...-r.1', -r <br /> �� f- _ <br /> INSPECTOR'S rp�=y Date ApProved -� � n <br />