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APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br /> evcrctt q 0�n� <br /> e 1 G <br /> CITY ENGINEERS . , <br /> EVERETT,WASHINGTON PERMIT N0. ' � " " � <br /> The Unde�,igned <br /> Hereby applies tor permission to � � <br /> At[he tollowing location � - _ <br /> SKETCH <br /> (Work to be done) . <br /> i <br /> � <br /> � --�—�� <br /> � <br /> � �_.'---. __. <br /> � I o-. ,. <br /> � , � , r�, = C � <br /> I ( , � :��. � ! <br /> i •�, / � �'�a���� ��. , . ��.J " ; I <br /> ' � ; i <br /> �t� � ,��, �� k ��� 7 - <br /> ' ; ��', � � ��,,�S , <br /> i ,I I :, : !--,_.�—'� i <br /> � ---- � ,.u� _ I <br /> j <br /> �' � --.'_, - i <br /> i � � <br /> i i �n ' ,ry ., /�� /��� � ' <br /> �r � <br /> � �,9 i i, r ; ;�\ �.,� �f' I <br /> � � .� 1_.� '��%/� ;�: l ��1 <br /> r � <br /> � <br /> I �� i ' j ' � r: IJ. ' <br /> I 's i � !�� ��1 � I <br /> , , - <br /> �,,, j �.�� , <br /> � ��� � _ — � ������� �r^=/ � ��' ' I <br /> r� / I �� <br /> �� ���� � �'.y'e'YJ Gr � � <br /> � .i • �. <br /> � y ( �/ :=� =�/�� �` � <br /> ;1 —__ ' <br /> I l- <br /> r. � � , <br /> DRIVEWAY SECTION The undersigned owner hereby agrnes to hold and <br /> NO SCf+1.E save harmless the City of Everett irom any and all <br /> � F--- � claims for damages that may arise because of installa- <br /> r� (i" ��P � tion and maintenance of the improvement hereto <br /> applied for and further agrees to remove same upon <br /> �30�.L-� ---- -- --..�.30� no[ice from the City and to replace public property <br /> damaged thereby. <br /> � Signature of Applicant <br /> � COPY Of- THI:;APPUCiaTIOfJ lU Address <br /> BE POSTED ON JOBSITE. � Telephone Number <br /> Cf�l L CNfiINf_FRING DFPT. 7!i&n:'f I . <br /> � '�.' I If�UR:� I;!_1 h!',L �:i��,,, i RU�: i I�i�: DatE �. <br /> CHECK LIST Fee � .. . <br /> W�ia� valve Dept. Approvals <br /> Drainage <br /> Curb&Gut[er Engineers_ <br /> Sidewaik Water �i �,- �.`.. „ .: � (_ 1� ���y <br /> i <br /> -� � Street f� <br /> j"� . <br /> _�� . ' � ) ,�/; _ � Communications _� � �'�+r '-. <br /> Inspector's Signature�` Traftic � � <br /> , � _ ��� ��r --j Planniny ' ' ''� •`i .= �/ . <br /> ! <br /> �6te � - <br /> Femarks , <br /> Note: Original to Customer <br /> � 1CopYtoFfle � n5?7 <br /> 7 Copy ro Inspectar � Approved by <br /> Date ApP�-oved <br />