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� APPLiCATION FOR RIGFIT-OF-WA�' USE PERMIT <br /> evcrett I , I��(.,� t,. <br /> � .� l. <br /> CITY ENGIN[EFS <br /> EyFRFTT� �n�ncu�niGTON PERMIT NO. ��� `� '�� %- �� _ <br /> \%' <br /> The Undersigned ��ll.i: ( � < . K�%r �c�',. ' � _ _ <br /> Hereby applies for permission to ('c.�c� . �� t 7 < � jj c,>: � !i- �.>��, �-' � � ✓ _ <br /> , <br /> At the follnwing location =f � i r�� ::% =� -a � _ _ <br /> SKETCH !7 7 '�_' '�G _ _ <br /> (Work to be done) ��. r � : <br /> i<..,.„,..) <br /> ; � <br /> I � <br /> ' � I <br /> . <br /> 1 � <br /> � ���t /S' �� <br /> � , r,.' �u <br /> I \ � \ I <br /> � �.4/� <br /> � . ��� ,.. rn ; E <br /> � �� ��� � � �1✓- <br /> I ' \ \ <br /> \ <br /> i � _� .� . <br /> 1 i 1_) _.I - � <br /> , I ��n <br /> i <br /> � � �� <br /> i � U ; <br /> I - ? <br /> i . � <br /> � I '� i <br /> , �� i <br /> ���� G I <br /> i i- � —j <br /> � ; — — � <br /> ! j. <br /> il <br /> i <br /> DRIVEWAY SECTION The undersigned owner hereby agrees to hold and <br /> NO SCALE save harmless �he Ciry of Everet[from any and all , <br /> �'--- "I c!aims fm damages that may arise beca�se of installa� <br /> ��� ��P tion and maintenance of the improvement hereto <br /> I 30" I � w3o" I applied for and turth?r a9rees to remove same upon <br /> �----.-� - —- - -- - , , notice from the City an�place public property <br /> dama reb � <br /> .� � <br /> S�g�a[ure of Ap cant <br /> . _ r /7 Y-',�.r .� 7(�. '7 _ <br /> -�.Ui'1 i f II i:; ;u f i , ., ,_.i: TG Address <br /> � � ✓/�-rr�-' <br /> 13G POSTED ON J06SI�(E. '�. <br /> � � i elephone Number <br /> Cl1LL ENGINEERING DEPL 259-2'�I i � �,S .i—/..i nf} <br /> . -', r{r r,;h5 I;Ef-Oi;!= COi'�.'STRUCi 10�.1 Date <br /> �,?�_ rT. .�C <br /> CHECK LIST Fee - � � <br /> Water Valve ��/,� SJ <br /> �e�t. Approvals <br /> Draina9e � �j�� � <br /> Curb&Gutter Engineers � r!•/!�'��-- .' j; '• 7 � <br /> Sidewalk Water� � <br /> �� � .����- ��'�—� � � <br /> SVicet_" : �� " :'-, r <br /> Ccmm�nications '-�-� � �'� ��- .-� . -��' .' <br /> Inspector's SignaWre Traffic <br /> Plannin9 � _ <br /> Date <br /> Rema:r <br /> Note: Original to Customer � - <br /> 1 CoPy to Pib� n �} ,, •� ,�' <br /> 7 Copy m Inspeclur ApProved by <br /> Uate Approved <br />