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-" .1PPLICATIOP! FC�n f{IGHT-CF-WAY USE PERMIT 11� J 8 <br /> L c'erett <br /> 1� <br /> . <br /> CI'(`% ENGINEERS ' <br /> EVE�ETf, WAS4INGTON PERMIT NO. 7�I�`' 4£� <br /> The Undersi9ned��/!�f��� ��L fL.sx.� <br /> Herehy applies tor permission tr �+-��� �0- y.Y��„�� ;r�� <br /> At the fullowing location_�C/�+�f-..�/j � 'y <br /> 1'�t�n r ,✓�ct.yy,a.�. �.�_��-'---- -- <br /> �J�Gi ��'~ �J E' �� <br /> SK�TCH <br /> (Work to be done) <br /> - IG � <br /> � ��„ C� y� <br /> , � ��S <br /> �_ �� <br />� � �� �� <br /> ) <br /> ORivEWAY SECTIOv The undersi9ned owner hereby agrees to hold and <br /> • NO ScaLE save harmless the City of Everett from any and all <br /> � — � claims tor damages that may arise because of installa- <br /> +�" � �p J� :ion and maintenance of tha impruve�nent herelo <br /> --� � a�rpiic�l for and further a9rees to remove same upon <br /> �io•�,,.-1--- 30" iotice !rom the City and to replace puhlic property <br /> dam ther y, <br /> ��e .���� <br /> Signature of Ap icant <br /> D/L �d.�i ��'�iss._—�_..- <br /> COPY OF THIS APPLICATION TO ddress <br /> 6E POSTED ON JOBSITE. �J_�j 2L/_�� <br /> Telephone Numbe"r � <br /> CALL ENGINEERING DEPT. 259-8811 <br /> 24 f;OURS BEFOR[ CONSTRUCTIOfJ Date <br /> � CHECK LIST � Fee <br /> Water Valve � <br /> Dept, qpprovals <br /> - Draina9e . <br /> Curb&Gutter Engineers <br /> Sidewalk -- <br /> — — Wa[r.r <br /> ' Street <br /> ' � -� � ' Communications � <br /> Inspector's Signature Traffic <br /> � � '. � � Plznning <br /> ate — <br /> Remarks <br /> 11 �50 �. <br /> Approved by -,�_ <br /> . .. � . . ;P::S;^r;-��: <br /> CiJSTOMER DateApproved � ' � �R ���.�' <br /> . . . � . .. ��u....�n:+. .....:,.ti<r�: <br />