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r.verett <br />� <br />(:I'fY ENGINEERS <br />EVFRETT, WASHINGTON <br />APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />109�Ei <br />� 7 / <br />PERMIT NO._�' "r-- �' I <br />I <br />TY�e Undersiyned ___(��_V:�_D �: ;:� 1 /�� _ <br />Hereby applies for permission to (�/'N S> n a� -i� �7 '�„1 � �, �,yi�y:y � � .�_ <br />At the fol�owing <br />SKETCH <br />fWor�: to be done) <br />DRIVEWAY SECTION <br />NO SCALE <br />{.�.-- _.—_ __� <br />I <br />I" LIP <br />I ----� <br />�.3Q.Y•____._______ . _..____�f.3O_�.� <br />CUcy ��i 1HIS;APPl �..;-�ilt���: I�_; <br />� E; POS�i ED ON J09SIl F. <br />�-;ALL ENGIP�EERING DEPT. 269-£�871 � <br />� 24 i�O�IRS OFFORE COlVSTftUCTItL; <br />CHECK LIST <br />YJater Va�ve <br />Drainage <br />Curb & Gutter <br />Sidewalk <br />Inspector's Signa!ure <br />Remarks <br />Wore: Originai to Customer <br />1 Copy to File � n 9�j �j <br />1 Copy to Inspec;or <br />7 �' <br />- � � <br />_ �.,_ f�i/l9��if:' �/� <br />The under;igned owner liereby agrees to hold and <br />save harmless the City of Everett from any and ali <br />claim: for damages that may arise because of installa� <br />tion and rnaintenance of the improvement herem <br />� <br />.applied� (or and further rees remov�� same upon <br />notic �from the City aid to re ac� public property <br />:3 aged th �e y � <br />� a _ \� ��� _ <br />Signature of Applicant <br />,a -�r, -��7N 5t� <br />i < ,- <br />� pt.�r ��Is <br />Engi�eers_ -��_Si-� <br />Commur.ica[ions <br />Planning <br />Approved b/ <br />Date Approved <br />