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APPLICATION FOR RIGHT•OF-WAY USE PERMIT <br /> evcreft <br /> e 10458 � <br /> .;� <br /> , �,�:_ <br /> CITY ENGINEERS `� ���� <br /> EVERETT,WASHINGTON PERMITNO. 7F — Sf� <br /> The Undersigned T fi a�w aS t �n F <br /> Herebyappliesforpermissionto �oncl�'�nrf 4 � ' �I �/� ��K� <br /> � - <br /> At the tollowing location 9 9 O I T h o m n-,n n .� ✓c <br /> SKETCH <br /> (Work to be done) �L �" F�� <br /> i � <br /> � <br /> � � <br /> , ,n <br /> � � � '�su�FAcE pRN�"I�GE I <br /> � � ' \ <br /> T �r- � <br /> , � � ,, _ <br /> ry <br /> J / o . <br /> \ '-, "' � i <br /> � ; �... <br /> �<7� 9 <br /> �� � : ! W.,Tn� �/ P� I <br /> (/� <br /> � �'�r � <br /> ' � � r, <br /> % o � ' <br /> i <br /> � <br /> � �� /. �� � <br /> ; � <br /> � � � <br /> / I � <br /> / I ' <br /> 4� <br /> c <br /> I <br /> ' �10 jrelr- <br /> �rF"'lF.w.G'..�_. <br /> DRIVEwAY SECTION � �� � The undersigned owner hereby agrees to hold and <br /> NO SCALE save harmless the Ciry of Everett from any and all <br /> � �—�2s�f�— -- - --"i claims for damages that may arise because ot installa- <br /> I" LIV tion and maintenance of the improvement herero <br /> applied for and further agrees m remove same upon <br /> �30'�„_ __ _____y3o" notice from ihe City and to replace p�blic property <br /> ���. . . damaged thereby. >�� V�El,/,}I T <br /> � . � <br /> �'v�,��,�_ �6- R7 <br /> Signature oi Applicant <br /> y 3 3v �:. � n,v i� t;�� <br /> �.�. �: , ��f= THIS ,4PPLICATiON i0 � Address I — <br /> �.. �".1(�,TLb ON JOBSI"i E. �� :_�J�=-r'�. ��. t-T'"� �il//1 <br /> Tclephone Number <br /> �..i�LL ll-JGlhd[ERING DEPT. 259-8811 �.�7 � 1)'�,� tr <br /> J�s iiUI:P.S HE"�-ORE CONSTRUCTIUW�� Date <br /> �,�/ ,,ii� �c: �,=,���, r ���— 87 <br /> CHfCK LIST � Fee ' <br /> Water Valve Dept p o . IS <br /> Drainage j <br /> Curb&Gutter Engineers� <br /> Sidewalk Wa�er,�� � 4� -/��pt � �-�/`� <br /> Sireet.—.t.::.__�.f=--_ — , <br /> Communir.ations �I� <br /> Inspector'sSignature Traf(ic �� � � �- � <br /> PlanninJ---- .' . ;� / % ,f,�_v_ � ��. . <br /> -l�te �,' `� _ 1 ' �v aw�� <br /> Remarks <br /> Note: Original to Customer <br /> 7CopytoFile ��[l,� � <br /> . i Copy to Inspector Approved by � � � <br /> . /�/�7�Ci <br /> Date Approved <br />