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, ._ <br /> APPLICATION FCR RiGHT-OF•WAY USE PERMIT <br /> everen _ s Q 7 Q 1 <br /> � �/ <br /> CITY ENGINEERS - � `�� <br /> EVERETT,WASHI(JGTON PERMIT N0._� � � __ � <br /> The Undersigned _' ��• ��� l� '����-=—` ' �- ' � � <br /> Hereby aFPlies for permission to � I �� - ��' � <br /> A[the following location '�_./ �.% � '� �- "� � =� �===�r — . — ---�- <br /> ;KETCH <br /> �Work to be done) <br /> -, - ri , �,�1�: , ;l . <br /> �; <br /> � i <br /> f t <br /> i <br /> � DRIVEWAY SECTiON � � Thc undersigned owner hereby agraes to hold aad �' <br /> � NO SCaL[ - . save harmless the Ciry of Everett frum any and all <br /> . —_---�- -�� ' claims for damac�es that may arise because of installa� <br /> � tion and maintenancc of the improvement hereto �,. <br /> � �-1��� ��P applied for and iurther a�rees to remove same upon <br /> __ I 30" � no[ice from Ihe City and to replace public property <br /> � ���—�-------- '1' � damaged thareby. / . <br /> � �i n . �•= <br /> ' Signature of Appij �nt _ �/J�� I <br /> C'� 'l� �:I rl//I/ � . <br /> _. __ _ _ _ ndd«55 <br /> I COPY OF ��FIIS APPLICl�TION TO � - - ' �� <br /> �� � ' -- �� G i.. .� <br /> i BE POST[D ON JOBSITE. '� Telephone'Number � <br /> � ChLt, i:NGINEERIP�G DF.PT. 259�8811 ', i - � �" / <br /> � Date <br /> � �.'L4.I;OL'RS [3Ef-ORE CC.�!STRUCI"IO,J I � ." -' � � __ <br /> iJ .G <br /> CHECK. LIST Fee / � <br /> i Wacer Valve Dep� Ap�rovals <br />� . Drainage �� 7j � 7�� _ . <br /> Engineers_ i� %% �-' <br /> Curb.4�Gutter ,� i <br /> l <br /> Sidewalk Witer ,�i�...,-i j;'._ �="�t%i,�-_�^' <br /> ,!' J <br /> Street�_ - � . <br />�I � <br /> Ccmmunicationa_. <br /> �—— <br /> �� I peclor'sSignaWre Traffir, <br /> / � � Plann�n9. ) . . <br /> .i _��_ �..�_ l'•� `-c�-. <br /> � <br /> �Se J ` • <br />� � Remarks �. <br /> Note: Oric�inal to Customer ��. <br /> � 1 CopY to Filc ��7 Q 1 ApprovGd bY� � <br /> 1 Copy to Inspector . � , <br /> ' . D�tc Approved <br /> I <br /> 1 <br /> I <br /> I � . <br />�.w. <br />