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everen- <br />�eJ <br />CITY ENGINEERS <br />EVERETT,WASHINGTON <br />L <br />APPLICATION FOR RIGHT-OF•WAY USE PERMIT <br />1��26 <br />PERMIT NO.�Y' � /� ` <br />� 1�A � ( ,� Gl�E-(, <br />The Undr.rsigned 1�L! �-- I` c IV !V C 1.J j ` � �.` �� <br />Hereby aVP��es for permission to G�n/ � 7� O C T �J� �(�f li � �(?i1/C lrj� i� <br />At the f��llowing location <br />SKETCH <br />(Work to be done� _ �_____ <br />G�cc= �'=so' <br />/F�/STin�G S�ptWAtK � cu� <br />1�--� 7 <br />� — <br />�730 <br />�U <br />� <br />� <br />� <br />0 <br />� <br />w <br />� <br />ORIVEWAY SECTION <br />NO SCALE <br />r--- ��'— — �j <br />I'� LIP <br />I 3p�� �30" I <br />(� '1 <br />C� �'Y OF 7HIS APPLICAI-10'J l0 <br />GL POSTED ON JO�SITE. <br />cr,�� i!-r�cw��r�ir�c nePr. 2ss-a[�t i <br />7,i I10URJ 56� u�il C(YJSTPUCTION <br />CHECK LIST <br />Water Vatve <br />Drainage <br />Curb & Gutter <br />Sidewalk <br />�u,,� "l.,o-�ti_ ��T.)� & � S -'y ��( <br />Inspector's Signaturc <br />��-, ti <br />ate <br />Remarks <br />Noce: Original to Cusromer <br />i conv �a F�i� 1. ��� 6 <br />1 Copy �o Inspector <br />5T <br />I The undersigned owner hereby agrees to hold and <br />save harmless the City of Everett tram any ar.d all <br />daims for damages that may arise because of installa- <br />tion and maintenance o( the improvement hereto <br />applied for and iwther agrees to remove same upon <br />notice from the City and m replace ublic property <br />d-emaged thereby. � AG u/itiE� <br />X !'�L/ Z('�,,� �_ u,. (��2CK(� <br />S�ature of Applican[ ��-7----- <br />�%�0 H/� 7wJnlE - ,�'/rL�FT7"�..,� <br />A dress � � <br />_ilo�C �i- <br />Telephone NumbeJ � <br />r �:/;�/>a <br />! . Date �� �p �� # <br />l/ 3ar-8� � <br />Fee � ��s <br />Dept. Approvals <br />n��.o��a �� p <br />L , <br />Date l�pproved 8 � <br />- 9- �./ <br />