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evcrer <br />� <br />CITY ENGINEEHS <br />EVERETT, VlASHINGTON <br />APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />U <br />:0155 <br />PERMITNO, ��- �� <br />The Uodersigned J�VE Q �CQnlN�/� <br />He�eby applies tor per.nission to Cl)NST'/1UCT /5'ASP!-1/�LT DR/VF= �NAY" <br />At the following location ='1/, �/1�l�QD PLACE <br />IWork to be dane) <br />1�Y <br />NO SCALE <br />�� � <br />DRIVEWA'I SECTION <br />NO SCALE <br />�--- -J <br />--- �s � <br />:�� LIP <br />30"�__. � .._ I 30�� <br />�� - T i <br />COPY OF 7HIS APPLIC/1TI(1N TO i <br />BE POSTED ON JOE3S1 iE � <br />CALL FNGIN[ERING DEPT. 259�881 I' <br />i <br />24 HOUFiS �EFORE CUNSl�RI�C?ir',f��� <br />� ' � <br />-bate <br />Notc: <br />_ . , <br />Original to Customer <br />1 Copy to File 1015 5 <br />1 Copy ro Inspector <br />3� <br />`_J <br />410 <br />� I.����� <br />,-� <br />�' EDGE� !�F <br />� F..�'/S T'N� r�4VEMUV T <br />�NEW R3PHRLT <br />DR I VEIn/AY <br />Thz undersigned owner hereby agrees to hold and <br />,q save harmless thc City of Everett from any and all <br />�p �� r; ��_ claims fur damages tha[ may arise because of installa� <br />tion and riaintenance of the improvement hereto I <br />applied f�r and further agrees ro remove same upon <br />noti -ttom thc City and t.� •eplar.e pubiic properry <br />da a e thereby. ��% �, <br />� fi'����'( % <br />Signat!yu�re o/f Applicant �C <br />/ � / � �i�ialt !i Ai ��Q�, �� <br />� Address ����u � <br />(\� ?S.� - 7 7v� _ <br />�� ` Telephone Number <br />���( � , \/ Date r .�,,y_ -- <br />3 �a7- � -+ Fee �i J � #7'�TL�' �� !1 l -'�i f�' � <br />_��1_L J <br />A� V � 11 �7�Nti�C.. � %.5 <br />Date A��proved <br />