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APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br /> everetl <br /> e 10392 �,�, <br /> �� �� <br /> f.ITY ENGINEERS �7/ - <br /> EVERETT,WASHINGTON , PERMIT NO. � L�� ��' �� <br /> _ � � — <br /> The Undersigned_� ' <br /> Nereby app�ies for permission to �"���- � � �'i� i�<'✓ <br /> At the following location� �i� � � � -� ��E <br /> SKETCH <br /> (Work to be done) �� <br /> � <br /> � � L� <br /> iA <br /> � `" <br /> �� �_� <br /> ` ' If? ;� <br /> \i /;. �j`� ,= <br /> �., � ___ _ . _. . ��. <br /> \ I��' <br /> �7 { ,�I <br /> I <br /> i , <br /> � <br /> �� � _ � C:'-l��G. �'r✓ <br /> — - `-� <br /> _ � 7/ _ <br /> --2�-- <br /> /7`' �>i���i� <br /> 1I� <br /> � <br /> DRIVEWAv SECTION � The undersigned owner hereby agrees to hold and � <br /> ',, NO SCALE . � save harmless the City of Everett from any and all <br /> '. �-- 1�� --- - - � �n� t claims for damages that may arise because of installa� <br /> �I" LIP n Y' /�F tion and maintenance of tbe improvement hereto <br /> f I I I �� �ji applied for and turther agrees to remove same upan <br /> 30 -� 30 n� notice from the Cit and to�e lace ublic ro�ert <br /> f' "1"�—�--- --�t'--�"I I��/�" .:,�1�� dam a -r�nY. v P P P 1 Y '� <br /> , _ <br /> � ��.b� Signawre of Ap � ' �/� ,. � <br /> 1 � Addr���` �-� . " ,.i'Y7� <br /> , COPY OF THIS APPI_If��,TION TO .�� , , `�___ <br /> DE POSTED ON JOBSITE. Teiephone Number <br /> . Cnt.l. f NGINEERING DEPT. 259f3���1 , � SC - ' � � / <br /> �24 iIOURS BEFOHL CCP�;iRUCii�Y;� Date / <br /> _ f�. ' .E:::.R- /��� 2/Z.>/-��, <br /> '�. CHECK LIST Fee -'�7� <br /> �� Water Valve ' �X �t ; v� DCA�t r v � <br /> � Drainage _'__%�`// �'��I' �'G^/ / <br /> Curb&Gutier Engineers CCY:____ FQ 2 � <br /> Sidewalk Water � �' - • � , pj� ' <br /> Sireet � <br /> �� � � ,, <br /> �:��, <br /> � CommunicatJons <br /> Inspe o�ignature „�_ Z _ <br /> Tra(f ic <br /> I 'L. � j � � (,n Planning � / � /" ` <br /> � <br /> -Date - C �� <br /> Remarks <br /> Note: Original to Customer <br /> iCopYtoFile 1n392 <br /> 1 Cnpy to InsPector ApPro6ed b �i� <br /> Lil <br /> Datr Ap�T <br />