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P.?PLICATIOfd FOR RIGHT•OF-WAY USE PERMIT <br /> egerett � '� (� �C� �y <br />, � _7� � <br /> CITY ENGINEERS ��� --�/ J � <br />` EVERETT,N1ASF'INGTON PERMIT N0. _ <br />' TheUndersigned�`������yRG J[11�N.�n/�� <br />�I � Herebyappliesforpermissionto CON.ST2UCT W/�T�IE� SEP•V/CE L/NE E/�ST .�N 4�['_r:r <br /> ST /=R�7M CUL�3Y TD /9LLEY 7'HEIII SaUTN /N I�LLCY <br />' At the following Iocation 4(.a�� Cr)�7M�f_' C/R L /�VE. _ <br /> � SKETCH <br /> �Work to be done) C nr1MERC�AL AvE. <br /> � --------- —��---._------�---�------ <br /> ��� <br /> r' � ' 1 <br /> r: <br /> nra srACE <br /> i�zv <br /> . 4��oa � <br /> • -� � <br /> _ � � i <br /> � I <br /> -- �-- - -------------- <br /> � �- - —,�#T- t=�LLC Y s <br /> � �, I - <br /> t X/STl/�l6 I,✓RTER 5EG1/lLE l � I N_Fl�/ l.,/<?TE,E' SE,C✓/CF L l/'�It= <br /> �//V� �i?�=vt.'aX. L 0 C/aTIUN� � � �BY GONi.<;�C'7;J/�) <br /> � i „" <br /> � I '-NEl✓ tN/�TE,P SER!//CE L/iY.F <br /> �F � ( (f�Y C/TY WATE�C' DEPT.} <br /> _ 5 VEiZ1rY LUCA"rldN aF. �' �o, <br /> F,`C! l-Pt , . . <br /> _;.- <br /> , , �� <br /> �= E co�ey �vE. <br /> ---_ _.�-�_�� � � <br /> ` ?i� EX15T/NG 6" C.I. WLlTEP. MRI/1/ _� <br /> DRIVEWAY SECTiON The undersigned owner hereby agrees to hold and C �. <br /> NO SCALE X`/, save harmle,s the City of Everett from any and all i <br /> C„`y�� claims for damages that may arise because of installa� �, i? <br /> /(�� tion and maintenance of the improvement hereto � <br /> �� applied for and further agree;to remove same upon <br /> 3 •� ____.__ . _. ._.�� notice from the City and to replace public property <br /> -- -- � damaged�reby j � I <br /> ! � <br /> Si�[ure o Applicant �—�I_ I <br /> p�,Ur► ��«� � ,.��.�_.E.� ; �� � <br /> 5i A�a�e55 <br /> � ;:�1;^I OI� TI-II5 :�I�1`�ICi�-IIUFJ -IU ��.� � r� �.4 � p ���� � <br /> —_C2(r <br /> .,.. :'OSTEO ON JOQSITE. "� Telephone Number , <br /> .,,.'� L [NGIhEERIIJG JFPT. ?!i9�BRi 1 J � ,j S3 L� f� � U � <br /> �� Date <br /> .. �; IICUii:ii5�=i_OHECOPdSIf;UC�ilOfd: ! �/� /—�� . . I .. . <br /> /V ` <br /> CHECK UST Fee ' <br /> Watar Valve �Ppt App ova15 <br /> Draina9� En ine � r`l��l� �O /�/7S 'I <br /> Curb&Gutter 9 ,� <br /> Sidewalk Water_ s � <br /> � �%. '��� J:._ Street �`.u'i � '�, <br /> � i <br /> �yl� CcmmunicationsJl% � ' ��' I <br /> Inspe r's Signature Traffic /�/��.�1/y/,._�,��...�_/,¢���- %� . <br /> Plannin!�� �'w' ` i"� l/—=t ��7( � �' <br /> Z-- � � / i <br /> Z- _ <br /> Date <br /> flemarks I <br /> Note: Original to Customer <br /> 7 Copy to File "�O`��J <br /> ta Ins ector � ���/ y ` <br /> 7 CoPY P APProve y )l ✓7XiY �G•f .%C�i—IJ�S � <br /> --� <br /> Date'Appwved� <br />