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APPLICATION FOR RIGHl'-OF-VYAY USE PERMIT' <br />_ everett - � � � � � <br />e��; 3,5s <br />CI7Y ENGINEERS � <br />E\+ERETT, WASHINGTON PERMIT NO.�J <br />T.ie Undersigned l� i�: N. ?'. � i� ;:.� �� _ <br />f Izreby applies for permission to �/' ��v S'J' �'` i� JJ � r=i �i-lA ��i �/��i n/. <br />i <br />At the following location <br />(Ihork to be done) <br />,.. <br />I DRIVEWAY SECTION <br />��. NO SCALE <br />I � � <br />�, �� ��� LIP <br />. �3Q'�__ _ —________�30 J <br />_� <br />. _ _____ . ._ _. . . <br />COPY OF THIS :�PPLICATION i G� ''� <br />BE POST[D Qf � IOBSITE. ' <br />CALL ENGI�E'RING DEPT.259�II871'��' <br />24 HOURS BEFGRE CONSTRUCTIOfJ I <br />CHECK LIST <br />Water Valvc <br />Drainage <br />Curb & Gutter <br />Sidewalk <br />Inspector's Signature <br />Noce: Original to Customer <br />1 Copy to File 11_ � 17 <br />1 Copy to Inspector <br />S r �. �.rj!,'� Ci�-" J <br />The undersigned owner hereby agrees to hold and <br />save harmless the City of Everett from any and all <br />claiins for damages that may arise because oi installa� <br />tion and mainrenance of the improvement here[o <br />applicd for and further agrees to remove same upon <br />notice from the City and [o replace pu6�ic properry <br />damaged (he y. <br />.��''.�.,�„� n�� <br />Signature of Applicant ` <br />1C�/f //fS7,�"�Gl ���'..-..a-.,.a�iG[/.�.-_ <br />Address <br />7yt� /SS z <br />Telephone Number <br />9- .iu -7 � <br />Date <br />Fee v%'�O J <br />Uept. provals <br />�r <br />Enginsers_.tr. �.a�,/ <br />Communications <br />Approved 6y <br />Date Approved <br />