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' APP' 'CATION FOR RIGHT•OF•WAY USE PFRMII" <br />` eV� i.0775 <br />..� <br />CITY ENGINEEF'� �-�7 <br />EVERETT,WASHINGTON PERMITNO. / ���J��S _ <br />The Undersigned � � y' f ✓= c = �' �� � � " � <br />Herebyappiiesforpermissionto �=��YS7�:���-7� rl ��' D�:,1,,, 1-in/= <br />Atthe(ollowingloc;tion_�+�����_�_-�: *�{.?�-z.i �v/ �".:�i <br />(Work m be done) <br />� I � .� >x�o � <br />� � <br />,Nsr.4�� ��c:��r-f 5'fnst,��.-,:r <br />,ro" CnN��. r�nt �3/zs �» cs 2S�'�sy- <br />'� ( t�I�D. ,-,�E N`- l/ <br />%�iL'P%�bt C�fZ I\tf�- ,k � ?}'i'AC� �i>eR - _ Y��U�'l'-�) _ <br />t'_Xi57'r,v. i�3 / << l: � iC� �i.�.r.;��.,ra � '_ <br />/�' L <br />_—._ _ � :. r �.. <br />k �,;- � 3'�i I C� I-I � � ,i n,.� <br />oarvew<r secnoN <br />NO SCALE <br />F � <br />� � I�� �IP <br />1�30i'___--_ -__-�30'"1 <br />j COPY GI 1H15 /�PPL�CiLlION lU � <br />�i OE PO::TED ON J06SITE. <br />� Cl�LL EPIGINGGRING C. �T. 759$111 I' <br />�; � I�'t;P,> I}�I"OfirCON9TRUCTIO�� <br />CHECK LIST <br />Water Valve <br />Drainage <br />Curb & Gutter <br />Sidewalk <br />Inspector's Signalurr. <br />Remarks <br />Note: Original to Customer <br />, 1 Copy to f-ile <br />1 Copy to Inspector <br />�_1177`1 <br />�`{� � - l ) <br />t; <br />The undersigned owner hereby agrees to hold and <br />save harmless the City of [verett trom any and all <br />rlaims tor damages that may arise because ot installa� <br />tion and maintenance ot the improvement hzreto <br />applied for and furiher agrees to removc same upon <br />notice from the City and tu replace puhlic property <br />damaged thereby. <br />Signature o( Applicant <br />Telephone Number <br />Date <br />Dept. Approvals <br />,� �p < <br />Engineers=/r c '�� Nr ^� /d�7 7 <br />Ccmmunications <br />Approved by <br />Da�e Approved <br />