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APPLICATION FOR RIGHT•OF•WAY USE PERMIT <br /> :,veretl 10 014 <br /> � <br /> CITY ENGINEERS �'L�� <br /> EVERETT,WASHINGTON PERMIT NO. <br /> TheUndersigned GA1Z � F= SUJ�ISL]!.l d�p�� - <br /> Hereby applies tor permission to Cr���T t2 F�t Z S � � l D 6 �S� n n 1 t/G. LAJ�U <br /> At the following location �Z�� 9 W A`�E p„ <br /> SKETCH I <br /> (Work to b:donel I f �-T I Z � <br /> [� � <br /> i <br /> I <br /> I I <br /> l� �I .�j2�q <br /> � ' No <br /> � <br /> 3 �i �.� <br /> ,,,�,: <br /> ,,.;, <br /> W _, � ; , <br /> �,,;a� <br /> � ' ��u.�� ��� �(�'� �`C� ��i:.`.�-�' . <br /> 0 <br /> � „ ' �l� � � C�qY(� .i l �F <br /> �� '�� QY/ ��� / ����r:�/' <br /> y,;� ''� ��;�,'i, <br /> 11� '\ 1.��I.I ' c', rN�(� ' <br /> �� �i'•:�� -,r(�' <br /> 1`� •���• . /�� <br /> � �ED6��f <br /> � � <br /> i <br /> �.r i5 3�� i , <br /> 1�, ! � <br /> D� � � <br /> � � i <br /> � � ���J�� � <br /> � � � <br /> �/ � <br /> � <br /> � <br /> � <br /> � <br /> DRrvEWav SECTiON The undersigned owner hereby agrees to hold and <br /> NO SCa�E save harmless the City of Everett irom any and all � <br /> � 25'-- -�- —+� cla�ms for damages that may arise because ot installa� <br /> tion and maintenance oi the improvement hereto <br /> f' LIP applied for and further agrees to remove same upon <br /> �30'� 30",,, notice from the City and to replace public property <br /> •�•-_.-__-__ ___. __ . � <br /> damzged thereby. <br /> � y�/ <br /> Signature of pplicant � <br /> • . �L,� �7��� ��C 5:� <br /> � CpPY Of- l HIS�1PP�IGi�I IGlJ i Ci � �, AddrreisS <br /> 6FPOSTEDONJOBSIIE. ' ` . .� � _cy�'�T�i�� - ��5 �/a/Gt7u� <br /> � TelePho��mbe9 r � � ._._. __ -- -. <br /> I CP,LI. f-NGINEERING DEPT. ?59�8`;i t �_y��„s7 - ' <br /> , �'ili��:�'I::, !,'_Fr)RC =�.C";�.. �'-tUr:liUu� Dete ,�//D 7- //-7f< <br /> 2. so <br /> CHECK LIST {F.ye e� <br /> Waier Vaive ����A � l'�� � Dept. Approvals <br /> Drainage ����7 ;��� � <br /> Curb&Gutter Engineers__�� <br /> Sidewalk - Water G� (� �'/ �� ��Y�T� .(�f( <br /> ¢ ,.. . �'' S/rcet �w � <br /> ", � i � <br /> � :� �y ��G���L " COfTIfflllnlCdllo � —_ <br /> Inxpector's5iqnature TraHic ��� 7� <br /> � <br /> Planning _ - -7� <br /> � � - ; ' � i <br /> `i ���- i .1--- <br /> �aie <br /> . � � - _ � �` ���'.. <br /> � . _ <br /> Remarks <br /> Nutr,�. Original to Customer 1 n n j. � ___ <br /> 1 CopY to File . � i I 1 . APProved by <br /> 1 Cupy to Insper.tor <br /> Date Approved � � <br /> 7/6/�-� <br />