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APP :ATION FOR RIGHT-OF-WAY USE P JIIT <br />everett - �{ O O C �] <br />e � o�, <br />CITY ENGINEERS <br />EVERETT, WASHINGTON PERMITNO. % 7- �i.� I <br />The Undersigned (� /� �1 '[ ' � !" t ' C- , <br />Hereby applies for permission to ' ��' �'�•j✓� % �� � � � �i� -� - T n/ -�� ' <br />i <br />At the fol�owing location /O// 7F.+i �� <br />(Woik to be done) <br />� <br />I DRIYEWAY SECTION <br />, NO SCALE <br />—_. _ ___ _.. <br />�___ J <br />I <br />30�LIP <br />__ I 30"J <br />r- � -- -- --r- -, <br />COP�' OF THIS APPLICATION TO � <br />BE ?OSTLD ON J0651TE. '�' <br />C/�LL LfVGINELRING DEPT.259-8N17 <br />:'4 HOUR:i [3EFORE �ONSTRUCTION'� <br />CHECK LIST <br />Water Valve <br />Drainage <br />Cur6 & Gutter <br />Sid�walk <br />Inspector's Signature <br />�ate -- <br />j:� C 6a %/ i�L f�! '� <br />A <br />I <br />The undersigned owner here6y agrees to hold and <br />save harmless tlie City of Everett from any and all '� <br />claims for damages that may arise because of installa- <br />tion and maintenance oi the improvement hereto � <br />applied for and further agrees to remove same upon <br />notice from the City and to replace public property I <br />dama e thereb � �� � <br />�d_ . � <br />Signa re ot App�icant —�� <br />.�Z�O� C"a CC S� � <br />Ad e� <br />� ��' ': 5 Z� I <br />Telephone Number I <br />Date � tii� �, <br />Fee � � � � <br />Dept. Approvals <br />�� ��� <br />Engineers � i � �,�«� � _ <br />Water _ <br />Communications <br />Plann <br />Remarks <br />Note: Original to Customer <br />,�o,�YtoF��� 10863 — <br />7 Co�;y to Inspector Approved by <br />Date Approved <br />