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everett <br />� <br />CITY ENGINEERS <br />EVERETT,WASHINGTON <br />� <br />The Undersigned y � � ,�f ' <br />Hereby applies for permission to _ <br />APPLICATION FOR RIGHT-OF-WAY USE PEFiVIfT <br />�� ; / f <br />CONS?. <br />10142 <br />PERMITNO. ��_�� <br />c_ <br />UCT 2Z' ASPNALT D, <br />f.t the following location � �03 '" =1 4 � � '~ <br />(Work [o be done) <br />1`� <br />NO SCALF_ <br />EDGE <br />PHVE �c <br />� <br />� <br />.. DRIVEWAY SECTION <br />NO SCALE <br />� �� � <br />f� LIP � <br />. �30'.�__�— _—��_- _ I 30 I <br />T •I <br />i COPY OF THIS APPLICATION TO I� <br />BE POSTED ON JOQSITE. <br />'I � �A'_L E�iGINEERING DLPT. 259-881� I�� <br />I � 2d IiOURS 6EFORL= CONS � RUCTION � <br />, ----__ _ <br />CHECK LIST <br />Water Valve i <br />� Drainage i <br />Cur6 & Gutter • <br />Sidewalk <br />i �.. ' <br />�, , <br />,l; � � �� �"%� <br />Inspecto '�Signature <br />�� - �� � 1 <br />—6ate <br />=)SPNALT <br />Wi4Y <br />The undersigned owner hereby agrees to hald and <br />save harmless the City of Everett from any ard all <br />��3 ;; a claims for damages that may arise because of installa� <br />—- tion and maintenance of the improvement hereto <br />applied for and further�grees to re ve : me uoo <br />notice from the Ciry and to repl �ub'c proper � <br />damaged tbcre6y./ /!� �� ' ' <br />�!�� !! �(i /-7�� r✓ /U%� /GGf n,-- <br />Siqnature of Apolic�T— .�� <br />�/l.`.'�i/�' �i� �::,.. ,'�i'.ri� ,�t'. . ,... . �.,- <br />Note: Original [o Customer <br />1 CopY to File � � Z q� 2 <br />1 Copy to Inspector <br />c`,' ��5 � S /O d <br />uace � <br />Fee L� ; J e� �:_ eC�,�-�a _7S_ <br />Eng <br />Ccmmunica� <br />Dep . App�ovals <br />� ����� <br />' �/'; <br />t% <br />: . <br />% <br />�"�3. �, i <br />L ` ;; /z/�� <br />r <br />Appr d b I ��/ ' , / <br />��l��i-(� J. .:J r.sn.r s,: c.� .`i �" r' � r- <br />Date A � � � �_�' J <br />PFroved <br />