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' ' APPLICATIO�I FOR RIGHT•OF-WAV USE PERMIT <br /> everett <br /> � � e <br /> CITY ENG!NEERS " � � � <br /> EVERETT,WASHINGlON PERMI'f N0.�� - - ` ,� — <br /> The Undersigned - '� "� '`� . <br /> Hereby applies for pennission [o '� rl'� ''�/?ri �'�" ��� � � — <br /> . r� � i. _ ,. , ✓ l/,!� . _--- <br /> At the following locacion ' -� <br /> SKETCH <br /> (Work to be done) <br /> DRIVEWAY SECTION The undersigned owr.er hereby agrees to hold and <br /> NO SCALE save harmless the City of Everett froin any and all <br /> � __.__ . . . _�! daims for damay::. :hat may arise because of installa- <br /> —�I� tion and maintenance of the improvement hereto <br /> �-�— +I�� LIP � I applied ior and turth�r agrees to remove same upon <br /> I � I _ _ ' notice irom Ihe Ciry and to replace public property <br /> 30' <br /> t 3�`�,�_ ._.�+� - , <br /> �dama d th reb <br /> �c+L �i�n ��.�..� <br /> Signature of Applicant <br /> 3 .�.i c. 9 /y. S< < �, :,3 <br /> �� � � Address <br /> ��COPY C!` Ilil;i I'vPP!J�.:i�l ft:,: �U ., � � '� ' �{O 7 i <br /> , i-,[ PO5TED ON JOb`!1�[. Telephone Num r <br /> CALL f-.NGIPIE[RIiJ� DCPT. 25��°�1 ' �. _,�� <br /> �4 IIUUhS 3�FORE ( [)id:�l :�� i i�.; Date �y I <br /> i _ - . . . � � ��• <br /> CHECK UST Fee <br /> Wacer Valve �7eot. Approvals <br /> �r :-,i . � <br /> Drainage Enyineers � %�- ��� -- <br /> Curb&Gutler -7 / <br /> Sidewalk 5�'r iJ°t'�' Water ��{ . �2�- � �' � �' '. . .!". <br /> StreetT`�'}d%it�-1�20�77 4 <br /> Communications — <br /> Inspector's Si9nature Traffic <br /> Plannin9 / <br /> 5�'�. )Jot�-' L_�'NP , /�,f � n .�.� ,Ll�-�7 `t��-' <br /> ✓ <br /> ate ✓ <br /> Remarks <br /> Note: Original to Customcr <br /> 1 CopY to Filc � � Approved by <br /> 1 Copy to Insper.tai --- - <br /> Date Approved <br />