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� <br />everetf „ <br />�� <br />CITY ENGINLERS <br />tVERETT, WASHIMGTOiJ <br />APPLICATION FOR RIGHT•OF-VVAY USE PERMIT <br />i', / ; <br />r : � <br />, i/.. <br />f. r, <br />w � l'� � ';^r <br />C <br />PERMIl"�,10. � ,.'_:,:i__ <br />-- - f - <br />TheUndersigned /�_,ti,<c�1l����"-° �T���� _---. ____ _. _ <br />Hereby applies for permission to - c% r! S T,Z� �' '� .�� 7 S�, 1•c PH�': .��� �[ .. <br />— -- J? LL—_ .- --- <br />� <br />At the folfowing location� i; ', `. 7�•_ r'C -. ���i✓ <br />SKETCH <br />(Work to be done) <br />DRIVEWAY SECTION <br />NO SCALE <br />� ._ � <br />. i" LIP _��j <br />----- <br />� <br />--- - ---' <br />30' .__ _____._ -__ __ -__ I 3G"� <br />Y <br />-JP'( OF TFIIS APP �ICATIO�J l0 �, <br />i'F POSTED ON J0651 iE. '� <br />I��i L �IVGINEERI�VG DEPL �:5&f3II1 i'� <br />21 HGUH� (3E; ORE COUSTRUCTION � <br />'_ _ _ <br />CHECK LIST . <br />Water Valve <br />Drainage <br />Ccrb & Gutter <br />Sialewalk <br />Inspector's Signature <br />Remarks <br />fJote: Original to Customer np <br />S coPv to Fi�e �, t' 0 7 2 <br />1 �opy to Inspector <br />.—, ; �,1.:N�',' <br />The undersignec owner hereby agrees to hold and <br />savc harmless the City of Everett from any and ali <br />claims for darr��iges that may arise because of insta��a� <br />tion and maint�:nance of the improvement hereio <br />applied for anU further agrees to iemove samc upon <br />notice from}he Cih� and to replar,e publicproperty <br />� <br />._ ,- .,..�..�.��nd- j � / � � <br />Date -- -�-- ; <br />�^3U-%7 I <br />� <br />Fee d��y��� � <br />Dep.t-�. /Approvals � <br />Engineeis_ ` 6f/.iir�i� — j <br />Communications __ . <br />Traffic _ ! <br />Planning .,, _ _ � � <br />i <br />. i <br />Approved by <br />Date Approved <br />8 <br />