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everctt <br />� <br />CIiY ENGINEERS <br />EVERETT,WASHINGTON <br />The Undersigned -� i�_ <br />Hereby applies for permission m <br />APPLICATI�IN FOR RIGHT-OF-WAY USE PERMIT <br />�. L_/� �; •, <br />10315 <br />%��,,, <br />PERMIT N0. ' /i " ' i = � <br />At the folbwing location ��3l 7 Ji7L_� N �J �1��. � <br />, r� -' - : i- , � <br />SY.ETCH <br />(Work to be done) <br />� MIN. 12�� �u� <br />�L <br />� <br />.� <br />� ---- <br />�- <br />N���� �=�SNrT��r_f r iw <br />� DRIVEWAY SECTION <br />NO SCALE <br />r-- ''--- �, <br />�� <br />I" LIP � <br />�.30-�_ �O_•____— I 30 � <br />-�1' <br />COPY OF THIS APPLIC�\TION TO � <br />BE POSTED ON JOBSITF. <br />CAI_L ENGINEERING DEPT. 259�8811 , <br />� 24 FIOURS [3EFORE (:OfVSTRUCI IVP:' <br />CHECK UST <br />Wamr V:,Ive <br />Drainage <br />Curb & Gutter <br />Sidewalk <br />r_�_.� <br />r.. _ � � � ` �t /:��i.' <br />" Inspector'sSignowre <br />�.� ,i" <br />, - � �� /� l_'_; <br />Remarks <br />; <br />;� <br />/� , i <br />_�� <br />,.� , �_ <br />., �� <br />.� <br />; <br />� __ <br />�i ' sl)L:'L Ul- ,�X�� T/NG I�,' <br />0 <br />�IA.�N. � � !_ 17U ��1 <br />Il-G-75 <br />rl'.r� <br />_ � , <br />� <br />The undersi�ned owner hereby a�rees to hold and <br />save harmless the City of Ec�i�tt f��om any and all <br />claims tor damages that may arise because ot installa- <br />tion and maintenance of the improvcment herem <br />applied for and furthar agrees to remove same upon <br />notice trom the Ci[y and to replace public properry <br />���`�.;/. D� <br />�R,�11'ature oi Applicant ' <br />4 /c= /�+�C SLJ <br />Address <br />���� �o� ri., ��UZO <br />Telephone Num� <br />_�_ z 48 z <br />Date <br />,�; ; „ � . ./. /i/1-�%j - <br />Fee <br />Note: Original m Cusromer <br />, �o,�Y to F;�� 10 315 <br />1 Copy ic Inspector Appro by / � <br />l i T'-C,L'�< <�'�Y"—%� <br />Date Approv d <br />