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APPLICATION FOR RIGHT-OF-WAY USE PERNII'( <br />`°�`�" 1074 4 <br />e <br />CITY ENGINEERS - <br />EVERETI�, WASHINGTON PERMIT NO.� �� s�� <br />TheUndersigned � C1��^lE- ��JE — <br />Hereby applies for permission to _ � U ��l �! `� � T" �5��� �-T ��c� / � <br />IZ�� TI �� l � 7�,u _ <br />At ihe following <br />SKETCH <br />IW�rk to be done) <br />��� �i �-1 i l �;f.�'�f � :J <br />/� � ��� �_ �y �///� !' <br />I DRIVEWAY SECTION <br />` NO SCALE <br />I` —� <br />�tl'_LIP <br />'� Y'_3_0'�___._. _-- ___ - _._�i'30"�1 <br />` COPY Gf- 711I$ APi'I.ICi1'1 ION TO <br />�i BE POSTED ON JOE3SI T[. �I <br />259-6811'. <br />'• CALL ENGINEERING DEPT. <br />I <br />'.t II(IUFS r,! !�ORE COP!STR'JCTIONi <br />� CHECK LIST <br />� Water Valve <br />Draina�e <br />Cur6 & Gutter <br />Sidewalk <br />lN ��7.l��;j. i , <br />Inspector's Signatwe <br />Remarks <br />Note: Ori�inal ro Customcr <br />, �o,�Y �o F��� 1 r% 4 4 <br />1 Copy to Inspector <br />The undersi9ned owner hereby agmes to hold and <br />save hzrmless the Ciry of Everett trom any and all <br />claims (or damages that may arise because of installa� <br />tion and maintenance of the improvement hereto <br />applied for and Further agree: m remove same upon <br />notice from the City and to re�lace public properry <br />damaged thereby. <br />� � -----'� �� ci^-r'� <br />Signat��e of Applican: � <br />Q.o-.''"�.x_ �=���L......,.._,,,oc�- <br />Address <br />--�-� �, - �syw <br />Telephone Number <br />.,\ -_��-�— <br />Date � <br />Fee �-----� <br />De^� Approvals <br />Engineers_�_ Y d�� � <br />� � ,i <br />`Nater t1.:r�t� �,�.. � /.-�r��'�' -r:--,, /� 'ilr,ur, <br />Svoet ���' ,i _S/ld'y7 <br />Commwiications <br />Traffic <br />Planning <br />. / <br />� ��/�,� <br />Y <br />Approved by <br />Date 4pproved <br />