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0 <br />everett <br />e <br />CITY ENGiNEERS <br />EVERETT,INASHINGTON <br />APPLICATION FOR R4GHT-OF-WAY USE PERMIT <br />10463 <br />�'��. <br />,���� <br />FERMIT N0. � �" - � � <br />The Undersigned D Ar r c l� C. N��.1 � �; u n <br />Hereby appiies fcr permission to r_ o n;� r�, c�� r_ 'L �� i� � n l� c/ l 0/w- <br />At the following location 3// 4 � Q'_=� <br />(Work to be done) <br />i7 <br />/ IL-----_ -- <br />t. : <br />�/c <br />___ I <br />� � <br />--'I\__—\ �IT'"'�"C <br />s i i y I� 2I;'� ` <br />\� Aa�'rti.`�� <br />; - /1�� <br />/' - <br />.�fi <br />.�� O � <br />—I N <br />Id <br />'_'_ _ L <br />Arl���;� elevt,liun Gf .:.aistinl <br />/�culv�rl ns �,eeF.snr�. ..` <br />� 6 /� /NTC� ,OiT�ii� .0 �.vr � <br />DRIVEWAY SECTION <br />NO SCALE <br />� Zs� —J <br />I'� LIP <br />30 __.._�..-_—�'Y30�'1 <br />�', � COPY Of� l lii; !�I'�LICATIQ'J l0 I <br />; B[ POSTED O(J.10651T[. '�� <br />i� <br />, CALL ENGINEERING DEPT. 25&8611 �I <br />�� 24 HOUPS �EFORF COfJSTRUC��lOU�, <br />' CHECK LIST <br />� Watar Valve <br />Drainage <br />Curb & Gutter <br />Sidewalk <br />I nspec tor's Signatu re <br />Note: On�inal ro Cusmmer <br />1 Copy tn File <br />1 Copy to Insiir.clor <br />Nu SccIE <br />���.�: .� <br />� _ -- 7 G <br />��L <br />� <br />The undersigned owner hereby agrees to hoid and <br />save harmless the City of Everett from any and all <br />claims for damages that may arise because of installa- <br />���� •, tion and maintenarce oi the improvement hereto <br />aS•% ° applied f�r and further agrees to remove same upon <br />notice froni the CizY and to replace puhlic property <br />�daff�� ed there/�by. /� <br />�.•oQ'l ��.�i�C..i]-I.ti J <br />Sign/�ature of Applir.ant�1 <br />�U�:I •�.�t�'� Ki.l:� i-1,_J• <br />Address <br />�ti _ `-, �J � ^,La <br />Telephone Number <br />Date <br />�� ; a , ��c� � �j <br />Fee __ ���___���/ ' �' I <br />Dek���l � S r <br />I <br />Engineerz � / _/ <br />Water� a_�. I%c�C /17Pe1-�SCi� � [� -�� <br />Street �G f' -- � <br />Commuriications <br />Traffic_� ��. �.�-=�— �c� <br />Planning � ' � �� a � 5 (o <br />1 i Ac �j <br />� `+� C7 J HPProved b�_ � � / -�/4 �� <br />- � �L %, <br />Date Appioved <br />