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i � , J� <br />� .._- - _ -- -- --------- _ — <br />� cverc,l <br />� <br />CITY ENGINEEFlS <br />EVERETT,WASHINGTON <br />The U�dersigned <br />Hereby applics fo <br />APPLICATION FOR RIGNT-OF•WAY USE PERMIT <br />10966 <br />� <br />PERMITNO. ` /�--�� <br />Ai the tollowing location_ 3 LO .�� �f �~ ST � V✓ r _ <br />(Work to be done) <br />S�F l�"/1 f3 GH'%D <br />di�= �U Gd7>.r�"/`v� � <br />�/7 ��j, <br />�C/ G'u.ivel-'f' y/�-_.r1� <br />DRIVEWAY SECTION <br />NO SCALE <br />�` � <br />� +I" LIP <br />�30'� I_3o�' { <br />COPY OF THIS APPLICATION TO <br />BE POSTED ON JO[3SITE:. <br />CALL ENGINFERING DEPT. 259�8811 <br />24 HOURS BE-FORE CONSTRUCTION <br />CHECK LIST <br />Water Valve <br />Drainage <br />Curb & Gutter <br />Sidewalk <br />Inspector's Signature <br />ate <br />Remarks <br />Note: Original to Customer <br />, �o�Y to F��� 10 9 6 G <br />� 1 Copy to Inspector <br />r . <br />The undersigned owner hereby agrees to hold and <br />save hamiless the City of Everett from any and all <br />claims for damages that may arise 6ecause of instalia• <br />tio d maintenance of the impravement hereto <br />pplie far and further grees o remove same upon <br />noti from th City d to r lace ubiic property <br />agcd tl r b . <br />�Signature of Applicant <br />.����,n 3sTN �� _ <br />A ess <br />fiic.l� [.c�kK�l <br />Telephone Number � <br />_ ues 4 S�3 S- <br />Date� I �� I � � <br />Fee <br />� ' Dept. Apprcvals <br />Engineers <br />Street <br />Communications <br />Plann <br />Approved by <br />� <br />P <br />