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--- _,.._ ..� - <br /> APPLICATION FOR RIGHT•OF-N�A'u' USE PEFiMIl" <br /> `��t.�� . 1074� <br /> � <br /> CITY ENGINEERS PERMIT NQ. ��!�� � <br /> EVERETT, WASHINGTON � . <br /> i The Undersigned �,�-��1 �% �1— (-,"N`�0�...) --- ,. <br /> Hereby applies For permission to G-�N!i72. Z S F T. C.�.��-''���'� � <br /> � At the following locatio^ '����'� -"� -> '' ..' � �� '�-�-' � ------- -- �. <br /> it�CETCH <br /> �Viork t�be done) �� <br /> �i'._" �-� i,'AG�ri�J �'� <br /> �I <br /> I <br /> � <br /> ,..�„i, - � I. <br /> �� � v � � <br /> r/�;� 1„I.:. ,., ., r,��� <br /> ��- � �,-� ..t. <br /> ,�,---- d <br /> DRIVEWAY SECTION , Th�undersigned owner nereby ag�ees to hold and . <br /> NO SCa�E save harmless;I�e City of Ever=tt from any and all <br /> F __—----J claims Tor d3mages tnat may arise because of insta�la- <br /> I applied ,or and funce of tl�.n improvement hemto <br /> �I" LIP �J d a ed the��y tf�ei ag�ees �move same upon I <br /> I 3�•� . _ . _ „f 'ty a d to re I�ce public property <br /> uon an mamtena <br /> � <br /> . _ I 3�' no Ice Trom the i '' <br /> r �- <br /> �____ `a� <br /> ' � Sgnamre of pplican[ � <br /> Sa 1 � / 33 �L N;�. <br /> '� ._ -.--. _ .... . _ _ ... . _ Address — � <br /> �� COPY l�F THIS 1PPlICATION T(i �� �'�\.�� R-/5 v��� e . � (.� , J 5f�7 Ci '� <br /> BE PGST[U ON JOHSITE. ; � <br /> Tslephone Number � <br /> CALL ENC=WEFt1�NG DEP i 25&8611 (o S9 ` � �'� ��� _ ' <br /> i 24 fiOURS 6[POR[ CONSTI?UCTION�I � ' '•�,, Date � %' I <br /> CHECK LIST y.� . . . '� ' . . Fee � ` 5!� ,� . ,, <br /> Water valve — 'Dept. Anprovals II <br /> . Drainaye � I <br /> �� Curb &Gutter !'n9ineers � �� %� ; �, . <br /> . Si� 'dewalk Nlater � � /�^a��,�=�i'�U-o-_�i!,��y �C�- <br /> Street ���� � � _— � '. <br /> '� i.ummunications <br /> inspeetor's Siynature Traffic ', <br /> � Planning � n '' <br /> '� � � 7 <br /> — ,�,_. , i:�! : I - � i� % � � a .'-'.-,..s-,:._ � j <br /> at-Ise— ,• �c.. <br /> Remarks s �� <br /> - 7 ! <br /> :Jote: Oriyinal to Customer ����� _ <br /> 1 Copy to File - I <br /> 1 CopY to Inspector Approved by � <br /> Date Approved <br /> I <br /> r- <br />