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APPLIC.ATION FOR RIGHT-OF-V'1AY USE PERMIT <br />everelt <br />� <br />CITY ENGINEERS <br />EVERET7. WASFIINGI�OM1,I <br />Za�4s <br />PERMIT IVO. / C!�- r`-'�.� <br />The Undersigned � � i..i ! f( ..,� L. <br />' J <br />HerebY applies for permission [o �`::n �t ✓�,.- L /•: � ��c>I�_,�,' lJ��./ -- <br />/ � <br />A[ the followin�i I <br />(Work to be done) <br />L <br />�-----`�/ — <br />_'_ /! t'-, .. S. �. <br />I, DRIVEWAY SECTION <br />NO SCqLE <br />�_— — � <br />�i�.� LIP <br />. �,30'� _—__—•7•30'�1 <br />COPY GF Tf-IIS APPLICATI� V TO <br />?E POSTED ON J�BSITE. I <br />G1LL [NGINEERING DEPT. 259�8811 I <br />i <br />� 24 HOURS �EFORE CONSTRUCTION� <br />CHECK LIST <br />Wator Valve <br />Drainage <br />Curb & Gutter <br />Sidewalk <br />Inspector's Signature <br />I;emarks <br />Note: Oriyinal to Cusromer <br />t Copy :o File � 0� 4 i3 <br />1 Copy to Irspector <br />The undersi�ned owner hereby agrees m hold and 'i <br />save harmless the Ciry of Everett from any and all � <br />claims for damages that may arise because of inst311a� ' <br />tion and maintenance of the improvement hereto , <br />applied ! d further agrees to r�ahiove same upon <br />notice f m; ie Ciry and tqrep}�ce public�prp,Qerty �'� <br />/ d" 6 ' .'-G��-- <br />Datr. � r, � , i <br />ii zz , 7� I- � �f- ii z/�� <br />Fee i <br />Dept. Approvals <br />i� 1, :',; ; , � <br />Engineers�., � �� ��- �� j°�� �. <br />Water�l) . d' -�z f.��-�,Pi�1=i�-�-�"u- , <br />,.;�_, _ Sveet .,� /:�:�!i� <br />� <br />Communications � ����� "�� N°.�-a-f.ti,• b-�.y�,. i %; <br />Traffic ✓ <br />Planning � <br />�' ���" <br />�i.,_:�..r� %; il�,....,r-�,���..,._.;l;tr- . <br />� <br />_ � ��.��c.- <br />Approved by <br />Oate Approved <br />