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! �I S— ` <br />verett . <br />� � �, <br />�J <br />CI'fY ENGINEERS <br />EVlRETI', VJASHINGTON <br />APPLICAT!ON FOR RIGHT-OF-WAY USE PERMIT <br />1.0�797 <br />PERMI'i N0. �1— /C 7 <br />The L'ndersigned _;�}ri� >�-i ' � h : :`.'i�1 /��� l -- — <br />Herebyappliesforpermissionto r�f'��•�'� f'i=��T �-� "l.-5� �iSJH�4t--=i7f:+i _�(- � _ <br />At the following Iocation / y�. r? �� ''�-= <br />IVJork to be done) <br />i/.; F_' K�!!:."�/A!:i� <br />� ORIVtWA'.' SeCTION <br />I IVO S:;ALE <br />r--- ------� <br />,. � +I�� LIP _�, <br />, � <br />�3��,.________________ 30 .� <br />i <br />—�-----___.____._. ._. ._._. _ ..___ . <br />(:OPY OF THIS RPPI.ICATIOr: TO �� <br />EE POSTED ON JOSSITE. I <br />I C;LL EIuGIN[ERWG DEP'�.'L59�3311 � <br />� 7_4 HOUR;; REFORE CONSTHUC710I�P <br />CHECK LiST <br />Water Va?ve � <br />Drainage ' � � � � ) <br />Curb & Gutter � ' . ' � � � 'I / <br />Sidewalk ,,i� �'� �� , � <br />n � <br />�� i <br />Inspector's Signature <br />Note: Original to Customer <br />1CopytoFile �07137' <br />1 Copy tc lnspector . <br />� <br />_. - -._=%--_�'_'_' <br />. ., _..._._.i <br />The undersigned owner hereby agrees to hold and <br />save harmless the City of Everett from any and all <br />claims for damages that may arise because of installa� <br />tion and maintenance of the improvement hereto <br />applied for and further agrees to remove same upon <br />noticr, from the City and to replare public prope y <br />da t . / <br />ignat e of Appllcan� --7 <br />�!%O/� !� �[/Cl�'�� <br />Aa`�55 %_�%�S 5/ <br />Telepho Number , 7 <br />��. �� <br />Date � S' <br />/ �_ <br />/,ept•_�(,>�r-.�' <br />Engineers i � <br />Planning _ <br />Approved by <br />Date Approvcd <br />