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.i <br /> APPLICATION FOR RIGIiT•OF-WAY USE PERMIT ��� <br /> everen �O C 12 /� � <br /> e J f(�. •,r <br /> CITY ENr,INEERS . �� � �� , � � <br /> EVFRETT,WASHINGTON PERMITN0. � � �' <br /> The Undersigned _ ` . <br /> Hereby apptins for permiszion to ` ` - ` `-�� = � <br /> ✓. <br /> At the following location -- - ' "��' ' ` ` � `� — <br /> SKETCH <br /> (Work to bc donel i✓ATtr� S�/�!/iCc � BE P,zO��i�.E..O <br /> F?o� 3.3-e0 �9th:. 1�/. .yG;�.�:rS �t�.,_.r <br /> I !�J.'�770:� �:� :� r #� /� � <br /> II <br /> �'\ <br /> �i� <br /> \�� I <br /> � I <br /> �I � <br /> � �G I <br /> 1 <br /> l <br /> ' m� _ _. -+ _ -4 : : '.' f�_--- <br /> c�-� -— , <br /> !-. <br /> �-.— %, - ,�. .�. <br /> __--- `� '�� _-�---'—`�-0 <br /> ._---�ff^ - <br /> -, ;.:� ��;, <br /> , <br /> 5 s�w,`�� V�/f� �� , <br /> ORIVEwAV SECTION The undersigned owner hereby agrees m hold and <br /> NO SCaLE save harmless the City of Everett irom any and all <br /> � �---- l�_j ------ � �.:., claims tor damages that may arise because of installa- <br /> � —� !���! tion and maintenance of [he improvement hereto <br /> i ���� ��P � ,- 1 applied for and turther agrees m remove same upon <br /> I �3� _ _.�.30--.� � ;� '� . �^� � 'v notice from the Ciry and to re lace public property <br /> ..�"------ - � . <br /> �• . J '�' damaged t�ereby.� <br /> �. /i, A�� �� � <br /> � i�, Sign re of� p icant <br /> ��S-�� ;-'sT S4� <br /> ' COPY OF THIS APPLICATION TO� A ess � <br /> � f',G POSTED ON JOBSITE. � ^����/ <br /> �� e ephone Nu ber i- <br /> � C�LL EMGINEERING DEPT 259�8811 5 -_t�l_� <br /> ��24 HOURS HE1=0RE CONSTRUCTION� ,r •�• �. Date� , — � - <br /> . . __._ . . •� � . , i .. <br /> �'� � <br /> CHECK LIST Fee <br /> Water Valve D=pt. pI %15 <br /> Drainage <br /> Curb&Gutter Engineer <br /> Sidewalk Water a 7 �� , <br /> Street .f1L �f � <br /> �,.,/ �(,'I.�• •. �' Communication;`� � - ' <br /> Inspr.Etor'SSi nature Tratfic � �" <br /> , � �� r <br /> Planni g� <br /> �� i i� s.��e� _ c T,-oss4: � ��.�.�� <br /> ate � <br /> I� — <br /> � A..��.� ��" _ <br /> Hemarks <br /> Note: Original to Cusromer � <br /> 1 CopY to File n � <br /> 1"`� �- Approved by t� i �y -, . � <br /> 1 CopY to Inspector ���� /�p �� <br /> � � 1-- <br /> �a�e Ann oved <br />