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APPLICATION FOR RIGHT-OF-WAY USE PERMIT
<br /> ' ' evcrett 10 5 9�
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<br /> CITY ENGINEERS i �
<br /> EVERETT,WASHINGTON PERMIT NO._ � .�_
<br /> The Undersigned -��� � ,
<br /> Hereby appiies for permission to ' � ' � � � _ _
<br /> At Ihe following Ixation_ " � � _. _
<br /> SKETCH
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<br /> ' DRIVEwAV SECTION The undersigned owner hereby agrees t- hold and ��,
<br /> NO SCALE savc harmless the City of Everett from �V and all '�
<br /> h-- "..''_. - � claims for damages Ihat may arise becau.:of installa•
<br /> f' LIP �l tion and maincenance of the improvement herem il
<br /> applied for and further agrees to ren�ove same upon
<br /> �30,'.{.— � �- -.�.30'..� notice irom the Cit and to replace public property
<br /> � dama�thereb t �
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<br /> Si ia CuregL,Applic nt
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<br /> COPv pF THIS APPLICATIOtv l O Ad ress ( �
<br /> BG POSfED ON JOBSIT-C '� �� 2-1 r� > ,
<br /> � I Telephone umber
<br /> � CAIlEN�!NLERWGDEPT.259-8Y11II� < 7 '
<br /> . �- .,__/ - '7�
<br /> 21 IiC�I!I?S f3EFORF CONSTRUCTiON�� Date - ,/
<br /> . . -. . . _. c.-' �-�i�� /�"�. �'!/u �,i �
<br /> CHE�.K LIST Fr.e —� �
<br /> Water Valve Dept. ApprOvals '
<br /> Drainage
<br /> Curb&Gut[er Engineers _. � ' '
<br /> SiAewalk Water n' o.. _i.i, � ;1f^,�. . ,'6---,� �S / :, �..�t.
<br /> Strect _._ .
<br /> . �' LfJ .t,E=�� ___ Communications . '�
<br /> Inspector's SignaWre Traffic ,
<br /> Planning__ � I
<br /> 31" ' - }, c,. , I/ C� J,`. :n ;'s%%' �' `.'/�
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<br /> R?marks
<br /> Note: Originai to Customcr �
<br /> 1 CopV ta File 1(15 9 3
<br /> 1 Copy to Inspector Approved by
<br /> Date Approved
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