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everM <br />CITY ENGINEERS <br />EVERETT,WASHINGTON <br />APPLICATION FOR RIGHT-OF-WAY USE PERMIT 1110 8 , <br />PERMITNO. 7C/-2 Co <br />The Undersigned l�l o r�f h S Ii i� i F p� , ��i F rJ :� c � � <br />Hereby applies for pertnission to C�' ^ S 1 ��� c'f' a 2 S� <o n c � r C� � � <br />/ / <br />At the following location_ _$�� �' F .S c.. n./ �( �� e�- <br />(Work to be dene) <br />ORIVEWAY SECTION <br />NO SCALE <br />�-- 2.S � -- —� <br />1'� LIP <br />i_o+ _—______ _ ao� <br />COPY OF THIS APPLICATION TO <br />BE POSTED ON JOBSITE. <br />CALL ENGINEERING DEPT.259�8811 <br />24 HOUflS BEFORE CONSTRUCTION <br />CHECK LIST <br />Watar Valve <br />Drainage <br />Car6 & Gutter <br />Sidewalk <br />�l�Utn ��+�.�t.:7� <br />Inspec(or's Si4 ature <br />J <br />1C/�alz'� <br />a�—B e —� <br />A�Lt (` 1� l� — W 1 D E�' ��� 1 <br />Remarks ' <br />�1f��/if- r.1i:f- <br />y�,��F /3Zqs•vieGE 11108 <br />�z�����,� <br />:1. ,` . <br />���\ ;' INSPECTOR'S COPY <br />� <br />The undersigned owner hereby agrees to hold and <br />save harmless the City of Everett from any and all <br />claims tor damages that may ariu because of installa� <br />tion and maintenance of the improvement hereto <br />applied for and further agrees to remove same upon <br />notice from the City and to replace public property <br />damageQ%thereby. 7 <br />�i �% �tfJ �� �' � 7�C21.�.__ <br />S�gmtuie of Applicant <br />�' qNiL-� (<,n�p LI//L iLL— <br />Addfess <br />Telephonel�luinber �3�7 <br />Date /���j _ �g <br />F e..� — <br />n <br />pt. App�ov s y <br />En ' �L �An -.._;1..._ _., '�� 9iu � 7 <br />� <br />nter <br />�_. . <br />Commun <br />� -- <br />APnrove'd�bv �� ( �+} . <br />' �Ib �I,i_ e flYlj��Ul •?f o- <br />Date Approved i� � (' O <br />1� , rr��i .�� ,� l �I ��� <br />