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reveren APPLICATION FOR RIGHT-OF•WAY USE PERMIT / <br /> r. _ �10 3 5 9 J,i u'��i �,!�� <br /> � , � }l <br /> ; ; � <br /> , <br />' CITY ENGINEERS '.' � � � <br /> EVERETT,WASHINGTON PERMITNO. � � - � <br /> i <br /> The Undersigned� L .:� i�� C-�.. • r •' � 1 "\' _ <br /> � Hereby applies for permission ro L!'i✓Sr z� '�'��= � ��. _ <br /> At tka tollowing location `�i v'�- ;NC-��� %�V�S%C'�� C.�i,��C—tG <br /> SKETCH <br /> (Work to be done) <br /> i <br /> / %-' <br /> ;�;. <br /> , � <br /> ,-�. -- , .•�- ^� <br /> .. .._�'l%r--. _ � _'-+ .� <br /> \ .- vjll`�`- <br /> , <br /> \ �NG`, � � <br /> I 1, � <br /> ' . � n�rs; � /`, <br /> , <br /> ; ' / <br /> �'1��� �� " _ 'iV�:�� �"_-,y'� .�ll'/�/���1/��� <br /> d ° � <br /> Q.9 <br /> o � <br />� <br /> \ i <br /> .jJ <br /> I R <br /> r_"" <br /> � <br /> � <br /> I <br /> � ORIVEwAY SECTION The undersiyned owner hereby ayrees to hold and <br /> i NO SCALE save harmless the City of Everett from any and all <br /> �— �rJ --- �- � claims for damages that may arise because ot installa <br /> I�� LIP tiw ana maintenance of the imprnvement hereto <br /> �, apP�ied tor and further aprees to iemove same upon <br /> 30'�_._ ____�.3� �� notice from tbe City and [o replace public preperty <br /> r�1' /�j.7�> dam d erebY. �p n <br /> 1.. ��-r�.__.l ' .�i �L-i�-V <br />� /l �, Signamrc of Applicant � <br /> i ;� ,�,�ll/9Fr o <br /> COPY OF THIS APPLICATION TO l Ad resd�'s �--���1�� � � '3 '� <br /> I B[POSTED QN JGBSITE. �S-� - N' 7 S .� <br /> I � Telepnaic Idumtmr� � <br /> 1 C/�I_I_ [N�RJ[[RINGDFPL 259-R811 / -"�_ �t. 7�- _ . ' <br /> 1,1 ii;��n�:> RFFORECOfaSTHVrTIOfJ�I `Date-� - - — . <br /> 7�'2 -�'' f(./ • <br />� CHECK LIST Fee / , <br />, Water Valve �ept pp O IS <br /> i Draioage / / � <br /> Curb&Gutter Enginee � '� <br />� Sidewalk . �� �:`.� Waier o �ti eo�S% c _��f� i <br /> ; <br /> �' , Street Y:-� : �_�,� _ <br /> \. i' C'e:q.v _ Ccmmunir,a�io s '��� " `— <br /> In ctor's Sig ature <br /> Traffic <br /> P�anning ���� � � <br /> � � <br /> - �! 3 �� r�—�-- ��- �- "�_^--"^ <br /> �--� .�.c,w � : <br /> Remarks --- '�. I <br /> INote: Original to Customer —� ', '� <br /> C 1CopytoFile 10359 —y— <br /> 1 Copy to Inspector Approved b �A/ � ��� <br /> "�' Dzte pproved <br /> f <br /> ! <br /> I <br />��_"__ _ _ _ _ _ _ _ _— � <br />