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evere;t <br />� <br />CITY ENGINEERS <br />EVERETT, WASHI <br />APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />The Undersigned � �Q 6` D �27�� <br />Hereby applies for permission to �-r �/1� <br />V ✓ �4 G /_ <br />At the following location G� �i 4�0`2 -' /� �� .S�% <br />(Work to be done) <br />nST�-I . E1�6E' ' <br />CEDAR ST <br />�--�--- �j ----c--_= <br />�i'0 SCALE <br />DRIVEWAY SECTION <br />NO SCALE <br />�-- /S � -- _ -''�l <br />�I' LIP / I <br />�30'�„ T //,_/ . . _�,30 J <br />V �� <br />COPY OI il{IS ":Pf'LICAllilh: iti <br />I!�E POSTE� ON JOBS TE. �. <br />I CAI_L FNGINEERING DEPT. 259-88i 1, <br />. '�i II�.iUf,S !.F_FOf1E CONb'TRUi:TION; <br />CHECK LIST <br />Water Valve <br />Draina9e <br />Curb & Gutt?r f <br />I Sidewalk <br />� l� <br />�%iiT'L'L <br />Inspector's Signa[ure <br />% 1 ".>/--_�� <br />�« <br />R� „a�k� <br />Note: Original to Customer <br />1 Copy to File <br />1 Copy to Inspector <br />10U98 <br />PERMITNO. /`-i-�ZD� <br />xr.s nN� cr�2e <br />2532 <br />� <br />� <br />x <br />� <br />� <br />�.�.�NE_In/ CO�i/CRLTE I�N/ <br />t�CISTI�UG tiiC c u�ls G�. 1�U7t-1� <br />S /T�tGi/NL K <br />----- --- — - --- , <br />I <br />- The undersigned owner hereby agrees to hold and <br />save harmless the City ef Everett from any and all <br />claim: for damages th;,t may arise becausa of installa� <br />tion anA maintenanc�; of the improvemen[ hereto <br />'�'4"'r applied for and furrner agrees to remove same upon <br />no[ice from the C'sty and ro r ace public property <br />a a d t reby <br />Si ature of Applicant <br />/ ; ���3_3 � �h•F ���y�i2 r <br />Address <br />�31o�-9i33 <br />Telephonn Number <br />C �1��'� /�o, - cf - -7Gf <br />p Jl! �/ Date n� <br />� �4��/��' %.S l) ��� ir�i `y��l� <br />Fee <br />Dept. Approvals <br />En�ineers_ � _ � � —� �' �J� <br />Water� <br />Stree[_:�T � <br />Communications <br />Traffic� i� / 7 tt. <br />Planning � ' � -5' %¢ <br />1C'0�$ <br />Approved b <br />' / <br />Date pprovy� <br />�J�C, %d 7� <br />