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1 APPLICATION FOR RIGfiT-OF-WAY USE PERMIT <br /> - everen <br /> � 1�J767 <br /> CITY ENGINEERS <br /> EVERETT,WASHINGTON PERMIT:JO � - I `9 <br /> The Undersigned!'�=I�1 L/L. t /_ ij�� ;J��= <br /> Hereby applies for permission to����;r�l',r� -' �-J - � S " " ;;,:,;� .�,r- �� /� � <br /> —`t"- <br /> At the following location��D/ `! �3 ':_-�- A;"; .�� <br /> SKETCH — <br /> (Work to be done) � <br /> ' • ,- ,_7. ; - �." ) <br /> � <br /> � <br /> � , <br /> � <br /> i <br /> I <br /> ` . <br /> i <br /> � DRIVEwAY SECTION The undersigned owner hereby agrees to hold and <br /> NO SCALE save harmless the City of Everet[from any and all <br /> � � claims for damages that may arise because of installa- <br /> I" LIP � tion and maintenance of the improvement hereto <br /> �0� J applied tor and farther agrees to remove came upon <br /> _ _ _. 30 notice from the City and ro replace public property � <br /> -�---�---- --,� darr,aed thereby.' • , ��. <br /> � /1�i1z_i�i.✓;�t/ <br /> :Si9n ��e o Applic5nt / <br /> � -- --- �/:'.��,Y �/�'7 --. � <br /> COPY OF l'HIS APPLICATON TO ! Address � <br /> BE POSTFD ON JOBSITE. ��: 7U, <. <br /> � CALL ENGINEERING DEPT. 259�8L'i i ,: Telephone Number �, <br /> �` .5,: - ll/l <br /> 24 i-IOUFlS GEFORL CCfVSTRUCTIUi�1�� Date — <br /> _ �� J � � <br /> CHECK LIST " <br /> � Water Valve Fee �7 <br /> 9-[7 /. — <br /> Drainage Dept.�provals <br /> Curb &Gutter ' � - � - . � � � Engineers //i i�%%��.,� <br /> Sidewalk . � �,� . . , . <br /> ,� '� <br /> Wa[er � - --�� . � ..�7-�,�._...�` . <br /> Sveet �. �i� e ' S� i79�/ 7 . <br /> —__ Communications <br /> Inspector's Signature <br /> Traffic <br /> Planning , <br /> ��te — S; _ /�/..�� ; � q :_, . .. ,'��,�, � � , ., �... /�.7 �..r <br /> ��_��+ <br /> �7 � <br /> Remarks — <br /> Note: Original to Customer — ' <br /> 1CopytoFile `�07�7 � <br /> 1 Copv to Inspector Approved by I� <br /> Date Approved <br />