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��_��� �.-�� <br /> � <br /> ��,�—`�� AP?LICATION FUR RIGHT-OF-WAY USE PERMIT <br /> � _ l' :�.� `. <br /> CITY ENGWL-GRS <br /> c1�cRETT, V�ASHING�i IN PERh11T N0 � � � <br /> TheUnde:signed l��J, .; � - 1�1 ;l�� �- _ <br /> Hcrebyappliesforpermissionto ��. --t„ ��' _ _ !.�V �, { <br /> :.[ the (ultowiny location_ -% ;' / ; /�; ),,- ��_ <br /> SKETCH '�" - <br /> (Work to be done) ��-' <br /> � � � � _ <br /> --VV— — <br /> �,G --- <br /> � ^ � ( i ^ � <br /> \ �� \! I <br /> ��� <br /> c� y� ,. i <br /> , � <br /> � � l, <br /> � � <br /> ,�. d � — <br /> � <br /> �� , I �� � V � <br /> I � C` I �\\\\ <br /> 9! -- <br /> I yya �.. <br /> l '---- <br /> I - . I <br /> i , <br /> ; <br /> I ____ - - -- -- <br /> I1`� - - - - — - - <br /> � ,��� <br /> ' �Ji <br /> ; ; ' <br /> � ORIVEWAY SECTION The undersigned owner hereby agrees [o hold and <br /> , NO SCaLE save harmless the City of Everett from any and all <br /> � r---- -� claims for damages that may arise 6ecause of installa- . <br /> �I" LIP tion and maintenance of the improvement hereto <br /> � �„30'�__ __ ___ __ 30"� aPPlied for and further agrees to remove s2me unon <br /> �-- . notice from the City and to replace oublic praperty <br /> damar�d erel�b. / <br /> �� � <br /> �'�nawre of Ap(� icant, <br /> _-__-- �� ��. ��nX 67 �/� 7 <br /> ��. COPY OF THIa APPLICATION TO � Address <br /> � BE POSTED ON J06SITE. I , ,�,,, �,,.�T <br /> CALL ENGINEERIhG DEPT_2,9�8A1 ! � Telephone Number <br /> . --,Si=.-L�'n n � <br /> . 1.: b!O�. �_; i;l-I UI � Cf�Ntil�riUU tlU�:ii Date <br /> _ 7 <br /> i l-._. i � �' ,��. <br /> CHECK LIST — - <br /> Water Valve Fee ,c�,� ,`� '�� -- <br /> � :. <br /> Drainage � Dept. Approvals <br /> Curb &Gutter � -� �.-/ <br /> Engineers '�. .�% �j,�/ <br /> Sidewalk � �--- ----r�-- <br /> Water� l�A� �� V�'i -- U�11,3-�._. <br /> Street_ <br /> Ccmmunications__ <br /> Inspector's Signature _ <br /> Traffir <br /> ,� <br /> Planning � ..�-:+°. -� ' I,i�. <br /> - i <br /> Date ��<_�,.. �G .rttcti.ir� � 11�1`1��'� ��1��-- <br /> flemarks <br /> Note: Ori9inal to Cus;omer -- <br /> i Copy tn Filc .? �1:�`� `; , <br /> 1 Co�iy �o Inspector � � q - <br /> pproved by"-._��(, <br /> ..._ .-_ ... �'. '�._._:_. '._._ ---- <br /> Date Approvdd V � ------ <br />