|
�
<br /> ;•�i,�c APPLICATION FUR RIGHT-0E-WAY USE PER6;iT
<br /> ; i�
<br /> CITY ENGINEERS
<br /> c'vEn'tTT, WASHINGTON
<br /> . PERMITNO. - �
<br /> The Undersigned_ 1_- l - -1 ( �_� .� , ;y ;l.,� �. --
<br /> 7' f� I , _
<br /> Hereby applies for permission to = �t I (_IV L� � ,� �J �-`, J j }.� '," �: '� - .� � � �
<br /> %�J�i �"i-��_�<_v
<br /> At the following location � - _ L:�I /f � ��-� [� E —
<br /> SKETCH � I ��' Il�(� `; I�'. lJ �_ ------
<br /> (Work to be done) N 0 T� .
<br /> -- ORIG'INAL R�iZ?I17 1� 5U� U ,_ � ; ,. -+ :
<br /> _ ...--------,..__. .. ' _
<br /> I 17A/( � > ,. .. " _."'_'_' ' '
<br /> ' _
<br /> A r.:�, f,Y �.�_ L_ J. _. ..
<br /> .'�-" ` —--- —
<br /> ' ��
<br /> 7
<br /> ��. _
<br /> _-- - --- `'�-;J1)_S__�__-�:
<br /> ; �'k15i iti ;� �uuG . ��u ri,�; I
<br /> SlUL Cl/ALI<. -- — —
<br /> ;`' �i -- =.�'_--:,
<br /> I '��
<br /> � �j�� -------__.._
<br /> //
<br /> (-� —�j M� I, / . . .
<br /> 1
<br /> � ' II �
<br /> uu sc�i.� � �
<br /> � x i � r�Nc• � �rri ����.,T�
<br /> I � ���� 9ZU! :'
<br /> ;� I
<br /> r�liii I ilO,Vi�)L s " LD,�� C. Cd,� --�=-� _;
<br /> � I,�o' �
<br /> DRP/EWAY SECTION ���� � The unde�si ned owner hereby agrees ro hold and
<br /> NO SCALE 9
<br /> !. ___.__ _ ,,, - � � save hannless the City �f Everett from any and all
<br /> � � � , ii i claims for dama9es [hat may arise because of installa�
<br /> I" LIP _�I � . tion and maintenance of the improvement h�re[o
<br /> �30" I _ � �gp��r , applied for and furthe�a9rees ro remove same upon
<br /> � � � notice from the City and to replace pu6lic property
<br /> damaged thereby,
<br /> , 'i:. . -- ,�../,
<br /> Signature of Applicant
<br /> ki�-L-
<br /> ", �,
<br /> �;.� ..� ,��.-i. �. :, i ,�..;� Address
<br /> �O�TEU ON JCBSI i E. � , �i �� �, �_ .; � ' -_ - _ -�.
<br /> ...L C-NGINEERIfJG DEPT. 25!� 831 ' ' � � '- I / I-� '�' �- TelephoneNumber �
<br /> � ;l - , ,� -
<br /> , �ur, rult�- � �r�: �, .�u� i �,;,�; _ _ _ L
<br /> Da[e
<br /> CHECK LIST �O�- _'o- J�
<br /> Watnr Valve Fee
<br /> Drainage Dept ppro als
<br /> Curb&Gutter /
<br /> Siclewalk En9ine�s / � � _5-
<br /> Water . LG . / 5 T� -� �i
<br /> � �
<br /> Stre�t r': �- > �
<br /> �t � '� Communicatio ��r�" —.�e�_ // 7_ �
<br /> � Inspector's Signature — ' - - � "� �
<br /> Traffic `�
<br /> Planniny- � ' / . � - -
<br /> Date � / .-1-1
<br /> �
<br /> Remarks
<br /> Note: Original to Customer
<br /> 1 Copy Io File 'i �• ,t •� - --
<br /> 7 Copy to Inspector ` - ' . .`. !� i- --.
<br /> APProyed � ,
<br /> '��� _._ ._'—____ - '
<br /> �p:itc Appi'dvod —_ _—.___
<br /> i
<br /> �
<br />
|