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. everen <br />e <br />CITY ENGINEERS <br />EVERETT,WASHINGTON <br />The Underxigned ��+ ' -��� - <br />Hereby applies for permission to _ <br />, � <br />At the following <br />(Work to be done) <br />APvIICATION FOR RIGHTAF-WAY USE "'RMIT <br />i <br />' I <br />� <br />h, °,-,���,� ��,,t,� �', . � <br />rfr'� C'/Ty i.t,'i7TG:E�' /11ii/12l � <br />�Zyy .�� �aC,t'i7�=.D ��-�r- � <br />r�n,v�t'C��, z..�5�-�,�r ,. <br />��L`f�/?�dJ $l,l�%``llJ�'GK— � <br />—N� ri �� ��9 r�.� t�x`PT� � <br />, � <br />��� < �, F�F�aR��/tl % � <br />�� � -� : <br />�•ri'�, ' !! r ;i'� �' �_ <br />' � a�'� � :-� !fl_ I ! °"/ n <br />� T' (. <br />i. <br />SoFr <br />11E30 <br />PERMIT N0. ! ' �� '�� r�; <br />� <br />� <br />! <br />' --� <br />� --- ���r.,Ty Liti="--------- <br />- ---{.s� ��'.. _., , <br />s,�le ,r , <br />�NC � /� �1 t ( <T x;,� � � � r. _ <br />�%r r ,.. , �. �: �. �i , •�: ,� a�t <br />� 1 r , , . , <br />� , . <br />� DRIVEWAY SECTION <br />NO SCALE <br />, r--- - -� <br />1�� LIP <br />�30'y_. _.. _-- — .. _�30 I <br />-i <br />COPY OF THIS APPLICATION TO <br />BF POSTED ON JOBSITE. <br />CALL ENGINEERING DEPT. 259�8811 <br />24 I;OURS �EFORE CONSTRUCTION <br />CHECK LIST <br />VJater Valvr. <br />Diainage <br />Curb & Gutter <br />Sidewalk <br />Inspector's Signature <br />Remarks <br />The undersigned owner hereby agrees to hold and <br />save harmir.ss the City of Everett from any and all <br />claims for d�ma�es that may arise because of installa- <br />tion .md mamtenance of the improvement hereto <br />applied tor and lurther agrees to remove same upon <br />notice from the City and to replace public properry <br />damaged thereby. <br />Signature of Applicant <br />Telephone Number <br />Dept. Approvals <br />Engineers <br />Communications <br />Plan <br />ApProved by <br />Dat� Anmm�ed <br />