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everett <br />� <br />CITY ENGINEERS <br />EVERETT,WqSHINGTON <br />APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />The Undersigned _ �i / ��' <br />Hereby applie; for permission�° �` <br />%3 F a ,. . _ �C�1-I,�.�_ <br />At the follo�ving iocation � l p 5 :{ " <br />SKETCH <br />(Work to be done) <br />� 7�/ \ <br />AI/ � <br />/Y '�� <br />LRI`/EWAY SECTION <br />� NO SCALE— — _ <br />�� ��" LIP � <br />I�,��__ __..__—__—T 3�1 <br />' C�.OrY OF THIS�APPLICATION TO � � <br />,�''� GE POSTED ON JOBSIT6, I <br />� i:,\LL ENGINE[RING DEPT. 259-Sgi i�, <br />>'-I IiOURS Ck-1-0R,G CONSTRUCTI(1��:1 <br />i, _ ;�; � �- <br />��te <br />Remarks <br />Note: Original to Cusromer <br />t coPy m F�i� 10 211 <br />1 Copy to Inspector <br />J <br />� <br />a <br />� <br />�n <br />rn <br />N�ul �st'Na� r <br />C:�e�e, / <br />i �.;• <br />�'�.�%` <br />�. ., _. <br />/�bfe : Wc�r� <br />co.k /��e.�/ ,�.,�`` <br />� /iCGt7�iosr Giyci <br />��`��� �� <br />%�� r7/f /SS[/L�� <br />j'•%7-75 <br />'- - �.r . ... <br />10�11 <br />PERMITNO. S �'� <br />�� <br />� <br />fcc�E� o/' �i <br />/� ,5 //i/, i ' <br />4 ✓.� <br />� A/Y.L Y' ' � <br />�iPDC'K.S(TYP.) <br />X/ST/�'VG p.��VE�NAy, <br />ST(J!c'/�') DRA//V/-�GE /AILET <br />%NG <br />The undersigned owner hereby agrees to hold and <br />save harmiess the Ciry of Everett from any and all <br />claims for dama9es that may arise because of installa� <br />[ion and maintenance of the improvement here[o <br />applied for and further agrces to remove same upon <br />notice from the City and to rep�ace public pro ty <br />damage ereb , / <br />_� � <br />i <br />Signa ure o Applicant � / <br />__5_� /! S �'� .C�..o GL/ <br />Address <br />3---�/�,�3 / <br />Te ephone Number <br />—�—�i — 7s� <br />Date — <br />Fe��!Z'�� F P <br />Approv � <br />—_,�,_� J�i r�_ ��.�'!.- i: <br />•J <br />Date Approved <br />