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eve'retl <br />� <br />CITY ENGINEERS <br />EVERETT, WASHINGTON <br />The Undersigned ��1��1 <br />HereSy app�ies for permission to <br />At the following <br />SKETCH <br />(Work to be done) <br />APPLICATION FOR RIGHT-OF•WAY USE PERMIT <br />\ <br />5615 <br />F�tOnC� S�D f��Y�� � �� <br />t/JATLI-1 DLAI�.1�L-�- <br />DRIVI:WAY SECTION <br />NO SC4LE <br />r-- -�s--- - � <br />� �1 LIP � <br />r3U+ T--�� � _..__i3O��1 <br />�.:UP�{ Ui- I HIS Ai'p�.ICP�II(J!J l(� <br />e[ POSTED ON JOBSITE. <br />cn,_� r_racir,�Err�itis �r�, ls�-a�ii i <br />�„ �'iillk; Ci I-0(7C CGP;b�I;C1CTION� <br />CHECK LIST <br />Water Vaive <br />Drainage <br />Curb & Gutrer <br />Sidewalk <br />/' J � <br />�J��� �C`T.. %JltzC <br />Inspector's Signature <br />��� /�� —� <br />w <br />—6a�e <br />Nole: Original to Customer <br />1 Cnpy to f ile '� !1 �� 7 <br />1 Copy ,o In,pe�_l�n 11 ( <br />�4= <br />�� <br />�C <br />�t �1 �� � i <br />I0097 <br />PERMITRO. /�' zC (� <br />�SY!-IAL� k./-l1S�17 <br />� UG �-- <br />ZS� <br />No .'�,�Lc <br />The undersigned owner hereby agrees to hold and <br />save harmless the City of Everett from any and all <br />claims lor damages that may arise because of installa- <br />tion and maintenance oi the improvement hereto <br />applied for and furiher agrees to remove same upon <br />notice irom the Ciry and to replace public properry <br />damaged thereby. <br />r — <br />..ignature App icant <br />� <br />d e- ss L� /� "P <br />–_..�S,f - � iii <br />Telephone Number <br />� <br />Dat�� � <br />. C Fee �� ���) ' -�� <br />Dept. Approvals ' �. <br />Engineers �jd�� ��_7 Y <br />Water � <br />Street /�,` '� i <br />� "'r.--7 <br />Communicatio s - . �y��� <br />Traffic - ��o � <br />Plannin � i ' �'Z'J_ <br />i,�_r <br />Approved by <br />Date Ap�lrov �-� �-- <br />��-- �� � �� �'f� <br />