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everett <br />�• <br />CITY ENGINEERS <br />EVERETT. WASHINGTON <br />The Undersigned /�! �- � <br />Hereby applies for permission to <br />At the following <br />APPLICATION FOR RIGNT-OF-WAY USE PERMIT <br />�L�L � T�-�it� <br />1028�. <br />PERMIT N0. Jl �� _. <br />L ��%.S %�- �G' <br />SKETCH <br />(Work to be done) <br />1,;/}L" 1C iJ 1= _. <br />N t'Al �O!�l G S' f f <br />;� ;! L I •�(�. <br />�a�sTir��, ��, <br />curr�rr <br />SID�!r/�L K <br />� � <br />DRIVEWAY SECTION <br />NO SCALE <br />� --- �� <br />�i" Llr / I <br />� 3��—._ _—.___—�'j�3O� <br />(COPY OF THIS APPLIGaTION TO 'I <br />BE POSTED ON J06S:TE. <br />CALL EIJGINEERING DEPT. 259Sf31 I j <br />2�; IIOURS [3EFOR[ CONSIRUCTI0i1. <br />CHECK UST <br />Water Valve <br />Drainage <br />Curb & Gutter <br />Sidewalk <br />Q'j l/7� <br />/A,o't/ ��/JN <br />Inspector's Signature <br />/�� /3 - ��, <br />Remarks <br />Note: Original [o Customer <br />;, <br />� <br />4��! <br />�� .� :.. <br />��.�.��i�. �J Y L �.1 1 � S; <br />�-�.. ,=. Li' - 7 ti <br />� <br />�ZNo. sr. — <br />The undersigned owner hereby agrees to hold and <br />save harmless the City ot Everett from any and all <br />claims for damages that may arise because ot installa- <br />tion anA maintenanr.e oi the Improvement hereto <br />applied for and further agrees to remove sarne upon <br />notice from Ihe City and� lace public property <br />damaged thereby. / ' <br />e <br />Signature of Ap licant <br />�� � � 33 .cJ � �r• !�r/, <br />Address <br />3ss- r y ,� <br />Telephone N mber <br />.- _�� �I� <br />Date �� <br />/�/n {-S � <br />Fee <br />� <br />�- %�-73 I <br />- �- r -- 7� ` <br />�.. ti / 7 � <br />1 Copy to File 10? � 1 ' ^ � <br />1 Copy !o Inspector Appro �� y / � <br />� �-�-`� 9-3o-7s <br />Date Approved <br />