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APPLICATION FOR RIGHi-OF-WAY USE PERMiT <br /> `""�" 10425 % " <br /> � ;�:�- <br /> �� <br /> '� ;;_��' <br /> ClTY ENGINEERS ���._ `; � <br /> EVERETT,WASHINGTON PERMITNO. � <br /> �% � <br /> TheUndersigned � J�"%1:J '�c- •' /:ii'i'�'.� :'�• <br /> Hereby applies foJ permission to_ l 7'� ��/�-t� � T /-� . �� : <.�t.-f--C� "'�_ z /r <br /> .v�.�/ '3 �� ,'/ /� / /�..yj �. �..+` .^_c.,f - ~ ?, v, �" � �[, -S <br /> At the following location 'i Gy � � �� - r � ' ' � ��-�� - .:c'-L <br /> SKETCH I <br /> ' (Work to be done) � � —'�i �— <br /> , �� � <br /> �, <br /> _y „ <br /> T �v, i <br /> �, ,5 � �I ' ti. ,-. S ' <br /> � ✓ � <br /> �� � � i <br /> � f'i'_i? . . ': -.c=:: "� I � . <br /> �J � �� /JT 'i. C� =[:. �!.)/�/ j ....-J� .r ' <br /> � :n/ -J�,Jc< -i �, "` �u..D 76-S <br /> � I� I �.,_.!'Y/G ._ 'U'.,L._ <br /> v� � <br /> � �---10� <br /> � <br /> � <br /> 35 ��� � � i <br /> � <br /> DRIVEWAY SECTION The widersigned owner hereby agrees to hold and �.. <br /> � NO SCAIE save harmless the CitY of Everett from any and all <br /> ��. I' ----��� rJ�J claims for damages that may arise because of installa� <br /> i,� ' ,�jl 1 ���1� tion and mainter,ance of the improvemer.' hereto <br /> applied for and further agrees m remove same upon <br /> �.30�+—� --�.3� ,%'� r�l' �,� notice from [he City and to replace public properry � <br /> � � �N� � � dam-a�g�ed"th� e"reby. . ��/ <br /> , %__�,�.�r< � .35`..u.: ;; f..E. <br /> � � �.7�� Signatdre oi Applicanj �' � <br /> � _ �� �y� ti ���,.��»3��z - �,�. <br /> COPY OF THIS APPLICATION TO l Address <br /> � BE POSTED ON JOBSITE. � � �f a� y � . <br /> ' C�LL fNGIN[FRING DEPL 259-f�81 7 I Telephone Number <br /> � .�"- y_�� _ <br /> � ,n �� ,i�.�s ��Ei o�[ i����ti�°;, �tuc,io�.,� oaie <br /> . . � . :.J� .n 1.._f._�. <br /> CHECK UST Fee ( � <br /> Water Valve <br /> Drainage ;j :i' 'i . D�Pt. p ov�ls �� <br /> Cur6 &Gutrer Engine <br /> Sidewall: Water N �N'se�p G/� <br /> �� � Street r .= �- ,� / /� <br /> � Communications �(�-�dL - -�C� <br /> Ins�aCmr' Signature Traffic ' � � � - " � <br /> -7 , ,-� . ,� �_ Planning- ��. � %' .. • <br /> -bate —._—___. —_ S'�uiEG N o J G. 9 <br /> ��lp.��s.(1i+'7,ALs�-rX .11aiTf,� l�F—l2�Jii <br /> emarks �D�D r,�S <br /> Note: Origfnal to Customcr � <br /> , �a,�� to F,�� �_0�2 5 - , — <br /> 1 CoPy to Insper,tor J y JC, Approved b �� �S/ <br /> � � � <br /> Date Approved <br />