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I <br /> ; <br /> � APPLICATION FOR RIGHT•OF-WAY USE PERMIT � <br /> everen <br /> � � � �o44s �,�,� <br /> / �U <br /> � CITY ENGINEERS ��^ J ` �' � <br /> EVERE i T,WASHINGTON PERM�'T NO. <br /> � The Undzrsigned =�����_`•��^ �...�r:' "� . - . .. .:. �' � <br /> � Hereby applies for permission to '-!' �� � �� � �A� -: L � .�" ��+'✓ <br /> � � � <br /> At the following location �7/`� / �:� " � •��+-�^ ^�� �"--F� / I <br /> SKETCH <br /> (Work to be done) <br /> \ <br /> \ I <br /> � \� ; <br /> , <br /> � �_ : � <br /> �,y <br /> �.� <br /> c�.�i�,<,_.�- N <br /> C'•�.'vCrC=. �' .�'vc/ � _—. <br /> � ��-�,� __._ I <br /> I ' I I <br /> � � � <br /> � �.� � ! <br /> °' � i <br /> � � I <br /> � ,��� h I <br /> ��� � i� '------------_____ ' <br /> �p / i <br /> ! p /n(1 <br /> � ;/>' I; <br /> �' / �1 � <br /> i � 1 i <br /> � `\� � <br /> ,� �,� � <br /> DRivEWav SECnON The undersigned owner hereby agrees to hold and <br /> NO SCALE save harmless the City of Everett from any and all <br /> ��----- claims for damages that may arise because of installa- <br /> — �7 � <br /> ��� —�� [ion and maintenance oi the im rovement hereto � <br /> I LIP q P <br /> �30'�—�--� 30"� � /'✓ ��' applied for and further agrees to remove same upon I <br /> ---�------� --� - / ���,lj� 1 j notice from the City ard m replace pu lic property <br /> � �{�i'"�� damag hereby. I <br /> � l �-y � � <br /> �� ,v`� ± ��� Signature of Applicant�Y � � , <br /> % � �� - -�/�n�=���.LG'S/ / � .o ���� <br /> .OV'( Uf �i�li!_�. . ir;�,i �.J�; „ � � � A d[�'rese'— � . �\� . <br /> � c�osrr� or� �ousi7e. ,""`r= -? <br /> Telephone Number <br /> I ';ALL ENGiNEERING DEPT. ?59-9811 ! [ �?� z 1 f-���__7� <br /> 1 <br /> �'l .. • c <br /> � �,�9 1-I�i_ ;S E[fOR�- CONSi�,U':TIO!2�'�. Date � / — � <br /> . r:— . . . . . � �, :j� l � 'i <br /> —/` (�`Y � 7/�/i I� <br /> � .HECK LIST Fee �/- � , <br /> - � '�'/ater Valve ''� <br /> nrai:r.�qe Dept. Approvals i <br /> �Cur�S�Gutter Engine � � <br /> Sid�:wal4. � <br /> �—�-.-� Water a c�P A Jv �. <br /> C. Street � <br /> - � Communications � <br /> In ctor'sSignature I <br /> Traffic . 9 sr. �� . <br /> / _ � C� -. / � Plannii � �'i <br /> are SP�'eV � N �'. '�/io.., .oSo.� �'�S-H, ' <br /> i I <br /> Remarks — I <br /> Nore: Original to Customer .; <br /> _ 1 Copy to File '1 Q 4�''� .�. � <br /> 1 Copy to Inspector Approved by i 9�/ <br /> Date Appro <br /> �+.. <br /> � <br />