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APPLICATION FOR RiGHT-OF-WAY USE PERMIT <br /> evereri �016 5 <br /> � <br /> CITY ENGINEERS 75 �� <br /> EVERETT,WASHINGTON PERMIT N0. <br /> ThCUndersi�ned OL/N ,Bf20s. CaN�STf2/lC7-/�4V <br /> Hereby applies for permission to G�NSTiQU CT 21 ' /-)S pl-1AL T .D21l�EliV.d Y <br /> At the following location 4� SQU�✓� AU� • <br /> 1 <br /> SKETCH 1 3 <br /> (Work to be donc) 3 � <br /> a � <br /> , � W <br /> _ � � <br /> � � ----- V <br /> > � 48a5 N <br /> Q <br /> � _ <br /> s � — � � <br /> � \ <br /> _ �_� <br /> , - <br /> SOUND AVE, =�� — <br /> a�z . � ---� <br /> z� <br /> ��S_ <br /> ur <br /> ! � W�� <br /> ' DRIVEWAY SECTION The undersigned owner here6y agrees to hold and <br /> NO SCaLE save harmless the City of Everet[from any and.II <br /> � � claims(or damages that may arise because oi installa� <br /> �---- -- 21 � <br /> � ��I' LIP i , t-: � [ion and maintenance of the improvement hereto <br /> �- ? �- applied (or and further agrees m remove same upon <br /> I 30'�__ _ ___./1.�- . -_�.30��� not�ce (rom �he City and to replace public properry <br /> � "� � / � damayed thereby. <br /> ! /J�7 k�1 �n I Y� 11� `- �I u f n <br /> � wq�cr �eYdr�lC C I�CQ� Siynatureof Applicanl <br /> a'�v_ MuL. �J '✓_� � 1��fl�jlj� __�O � c�Sr�C z / 7S�i.�erc�/� <br /> � L'Oi Y t�f- �� IIIS :V'PI IC/ATI(�Fl T!1 �� � Address <br /> I}I_ PUSILI�OWJOl351T(_ � ' <br /> Telephone Num6er � <br /> C�t I_ FIJC��N[ERING DEPT. 250-8t311 I � 3 '�j7 I rL. <br /> J <br /> 2d HOUHS 13N`ORf-. CONS�iRUCI"ION�i �,� � � Dat� ��� �� <br /> ll <br /> CHECK LIST �)�I Pee <br /> Waier vaive J , l�l Dept. Approvals <br /> Drainage � <br /> ���� ;- G4 Z � <br /> Curn&Gutter Enyineers 7y/ ` <br /> Sidewalk , l�cq�r � �///_i4n-� <br /> ater_� '� <br /> - / ��>..+ r i� Street � • � <br /> , . --�y--- _ �,- <br /> � / � ��-i ,. I �,' . Communica[ions�r/ —�.-�-- �'--�p/� _ <br /> Inspector'sSighaIDre T•affic i�' ��� �/� <br /> - , Plannin�- <br /> I ' � <br /> �te -- <br /> Remarks � <br /> Nnte: Original to Customer <br /> 1 �'epY �n Filr 1016 5 f <br /> 1 CuPy to InsP�ctor Ap r v d bV , <br /> - W'�cl�..0 __�-�-J�- <br /> yDate A� - <br />