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. ._ � _.�.--�..X_. _.�-_..... - <br />� �,. <br /> I ' ` <br />� <br />� � „�,i,�e„ APPLICATION FOR RIGHT-OF•WAY USC PERMIT <br />' � 1Q9�!" <br /> CITV ENGiNEC•fiS <br /> EVERGTT, WASHINGTON PERMITNO, / I'"' ���'��_ <br /> � � <br />� TbeUndersigned - � ��l/> fj�, � j c . . ..... . . �� �_ <br /> . . . ii11v/- <br /> Hereby appliut fnr permission tn � � �7 .�Z �- --- <br /> ------------ _�!��!. T_.:.f- — �-,� 1----��Z`:�11i�i�,r_L�/I. r,i. . .. _ <br /> ---__T.._.. <br /> '• ------------ <br /> At the following location c.�U' .:� ) - - --� ��------- <br /> ._'�-� F '�-<:-'� ...._.���.'_ <br /> SK[TCH _._ <br /> (Work to be donc) � <br /> SCi� �/�'T�T/�'C/Y�j/ <br /> � <br /> r � <br /> i <br /> �NO SaC.4LE CTiON Tha undersigned own�r hereby agrees ro hold and <br /> �.____ ___.� savc harmles•.the City of Eventt from any and all <br /> � � _ claims for damages thnt may arise because oi installa• <br /> ��__..!.� ��P �-7� tion anA maintenancc of the improvement hereto <br />� ����—Ir i �30" I oPP��ed far end tur�her aprecs to removr.samc upon <br /> -�--"f�- -� ---- �-- - -. ... •f <br /> - notic,r. from the Ciry and ro replace��uhlir. properry <br /> damagc� therr.b <br /> `' / _ <br /> .�a /✓_�,s i1 ., <br /> Si�i�dl��rU�Applif.,int � — -� <br /> COPY pF THIS AP?UCATION TO q�����35 — <br /> BE POSTED ON JOBSITE. � J�� �� _ ���-A,� <br />� CALL ENGWEERING DEPT. 259�6811 T��P��oie N�cr `� '- , !� <br />� 24 HOURS BEFORE CONSTRUCTION -"'�'r�—��— <br />� - Date n ---_ — <br /> CHECK S.IST /""/ 5��77 <br /> Watar Valve Fce---�/�'�"�-- <br /> Droindgc . Dept. pprayals <br /> Curb&Gulter �' �' � <br /> Sidewalk Enpineers_ <br /> Waler <br /> Strr.et <br /> Inspector'sSignatuie Communications � <br /> I TraNic , <br /> Planninp <br /> �6ate — <br /> Remorks - <br /> Note: Griginal to Customer <br /> 1 Copy to File �p g g 4 <br /> 1 Copy to Inspector lapproved by <br />