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�.�.�..� ��.,_..... <br />, APPLICATION FOR Rll"sHT-GF-WAY USc PERMIT <br /> evrrcri <br />� � j�. �_ ��.�_ .. <br /> CITY [NGINEERS <br /> � �'_ <br /> EVERETT. WqSHINGTON PERMITNO._��" '" . <br /> The Undersigned_r'-�_�� ��_ � � � � � � <br /> . ��� :'� .� � . <br /> i�C — -- <br /> Hereby applies fcr pe nission to � !./�/ST:�U�: T r-� '�i <� �� /.�5J'y;'f�_.'j 1�7 ri/ _ _ �, <br /> / <br /> � <br /> At the follov�ing locatio;_ ��U � // T� j%,�. 1/J._ r? p',� a �� ------ <br /> . SKETCH -- ' <br /> � (Work to be done� � <br /> `.�`r j�'TY�-rC�ff�17 <br /> i ' <br /> r <br /> II <br /> I \ <br /> DRIVEwAY SECTION The undersigned owner hareby agrees tc hold and � <br /> NO SCALE save harmless the City of Eve���tt from any and all <br /> , �— ---- �--� claims for damages tuat may arise because of installa� � <br /> ��� �ip �7l tlon and maintenance of the improvement hereto ! <br /> . —� � applied for and further agrees to remove same upon � <br /> � I 30 I ,_�30" I no[ice from the City and to replace public properry � <br /> I'��Y------ ._. ..�y <br /> dam thereby. <br /> Signatur f Appli a �, <br /> i —� ---. . _ . ___ . .. . <br /> COPY OF THIS APFLICATIOi� TO . Address �� � <br /> �� I:EPUS7FDOfVJOBSITE �� aU�� i7- �Z�LV Ch/ • �UMOtuJS �I�J�f�Glyl�', . <br /> Telephone Num6er <br /> ; CNLL [fJGW[FfiING DEPT. 259�£�8'. i ��. �-� �_ / 1G � I <br /> L�-4-�-��-{— <br /> ': 24 I�IOURS BEFORE CCNSTRU`: I iu��! Date � _� �_�� ; <br /> CHECK LIST Fee ;/„''�'� <br /> Water Valve <br /> Drainage Dept. Appf�yals <br /> Curh &Gutter Engineers �� � _L��-�J —_ <br /> Sidewalk Water <br /> � Svee[ <br /> ___ __ _..__, Ccmmunications _. <br /> Inspector's Si9naturc . <br /> Traffic <br /> Planning <br /> �ate ------- -_ _---- _ � ' <br /> Remarks — --- <br /> Note: Original to Customer <br /> 1 Copy to File � 1 �1 g <br /> 1 Copy to In�pcctor Approved by <br /> Datc Approved <br /> — �7� <br />