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everen <br />.e <br />CITY ENGINEERS <br />EVEPETT.WASHINGTON <br />The Undersigned �.^t' T/.� � <br />Herzhv applies for permission to `': <br />At the following iocation ^. ZO'7 <br />SK.ETCH <br />(Work to be done) <br />? C;f� � <br />�'t',�K —J <br />�.:,.1; �t,;,� <br />n, ert �L <br />_I .�/ <br />APPLICATION FOR RIGHT-OF-WAY USE PERMIT 11180 <br />.,- � ,� O J�f �-- <br />�L•' !d ��L/f1� <br />i <br />Ot F��r. <br />QID6. <br />� 32 0 -� <br />� ? c�1 r�tP.R � <br />._.. ,.._. <br />� <br />.j , <br />SC- �u ef- <br />`:^'_ A� UlC :, ,,GhE. <br />�� N <br />_ � _,,., f_ r � - }' �'% <br />� n <br />Iryi,�r,;] yi ���Fway <br />%,_ .�'..: ,{'r. mo �/�'�v � <br />DFIVEWAY SECTION ` .� � _� . ��r � � � (-Z� � <br />{� NO SC4LE �G�•'-� � 'Y(� <br />I 2 ` —�� � <br />� I" LIP / J <br />�30�— __ _—_ —_ . __._.►1'�'—�'1 <br />(COPY OF TH�S APPLICATION TO <br />B[ ?OSTED ON JOBSITE. <br />GALL ENGINEERING DEPT. 259�SR71 <br />24 HOURS BEFORE CONSTRUCTION <br />CHECK LIST <br />Water Valve <br />Drainage <br />Curb & Gutter <br />Sidewalk <br />Inspector'z Signamie <br />�,� � 1 ,.`'' <br />� , <br />INSPECTOR'S COPY <br />PERMITNO. %F -- �I <br />C :��.1C i2c s�. <br />�r �, �,• de �k.. <br />The undersigned owner herehy agrees to liold and <br />save harmless the City of Everett from any and all <br />claims for damages that may arise because of installa• <br />tion and mainten3nce of the improvement hereto <br />applied for and further agrees ta remove same upon <br />notice from the City and to replace public pro�frty <br />dam �ed� eby. ��/ � � � �-+'-^. <br />' 17i/(/!� !4/ �``J��"i����•'� <br />�ignatu e o Applicant ., . <br />1/ �, .:..L� �� �..�J <br />Address <br />: . - �v'. �..Y;' <br />Telephone Number <br />_�Li <br />f�. � �� . �y <br />Date <br />,._�., <br />Dept. Approvals <br />Communications <br />°�anning <br />�, <br />�, _ <br />Approved by // � 1� � <br />��,�,,'ip",,�_� ._�al�, <br />Date Approved � � �7�.: � � <br />,':'lti I %-., <br />� <br />