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�� _ ._. _ _ <br />' everett <br />� <br />CITY ENGINFERS <br />EVERETT,WASHINGTON <br />APPUCATIC+PI FOR RIGHT-OF-WAY USE PERMIT ��^��� <br />11017 <br />'7 7� � <:, S �-' <br />PERMITNO. �''�rJ�'�i:��� <br />The Undersigned —%� /[ r.�Fi:21� CE� f< <br />Herobyappliestorparmissionto /'nN�>�n.T �}___�D ��S�i:f7,:.T ��wi <br />� / <br />. — <br />V_" <br />At the io6�...^_ :xation � �^I� � J�v - y,�. �>' �(_ <br />(Wo�M. to bo done) <br />� � ORIYcWAY SECTION <br />NO SCALE <br />� � <br />[ I" UP <br />�j�-- �3� <br />COPY OF THIS APPL.ICATION ; O <br />$E POSTED ON J06SITE. <br />CALL ENGINEERING DEPT. 259�8871 <br />24 HOURS BEPORE CONSTRUCTION <br />CHECK LIST <br />Watnr Valve <br />Draina9e � <br />Curb & Guttc� <br />SidewalY. <br />�nspector's SignaNre <br />ate <br />Ramnks <br />Nota: Original to Customer <br />, �oPY �a F,�e 110 i 7 <br />1 Copy to Inspector <br />5�6 riTi ACf1�D <br />b� <br />o�� <br />U� <br />The undersigned owner hereby agrees to hold and <br />save harmless the City of Everett from any and al� <br />ctaims for damages that may arise becausn of installa- <br />tion end maintcnance of the improvement hereto <br />applied for and further agrecs io removc same upon <br />notice from tf7e Ciry and to replace public property <br />damagedlbcfpb/y, <br />��.L['L.Ln� C�A� _ <br />Signature of Applicant I <br />.�.SC�f /N�S k" SC✓ �.��..cxtL. GG�-�.�. <br />Address <br />��.� /s S "3 <br />Telephone Number <br />v-::u -77 <br />Date <br />Dept. Approvals <br />Engineers <br />Communications <br />Planning <br />Approved 6y <br />�.� .----.._.. <br />