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- - � �. , .�:_-�- <br />� <br />� --- <br /> M � • <br /> � � " APPUCATION WF( RIGHT•OF-WAY USC PERMIT <br /> cvcren ,_('�t��7 <br />, � <br /> CIlY L'NGIN[ERS r1 t'�' <br /> fVGRf:TT,WnSHIi!GTON PF:RA4fiN0._. � .��(-� • � <br /> Tha Undcrsigned.���� ' ��T.nl� � LV/L(.L,�LYL r�-�� q � <br /> HcrcUy applias for Permission to _�.[=�l�?�..�..�.-7•��.—[--�`I ��=��If�'-j�'4 ' -� --.. .._ . . <br /> __ ._. _._..--`--'-----. .____...--'---..___"'--'----•�- ^. -�--"-.-`. • --._. . ..._ __- ._. . . _. __. . . <br /> At the(ollowing location.�;,�',r,"7�J �� �b�7'1-1.__/���L�._c_-�'�--'------ ---- ------- <br /> SIcETCH '_ ---- - --------- - <br /> �Work to tx�donc) <br /> �J/i:� �/7��f�/1 <br />� b<< <br /> r <br />' <br />� <br /> I <br />� ORrvEWAV SECTION i hn undersigned ownon c�reby nAreas ro ha�d and <br /> NO SCALE savo harmless the City of Everett from any and all <br /> I.-�--�— ---------' claims for damapes that may arisA bncause o!installa� <br /> I <br /> � tion und maintenancc of tha improvement hereto <br /> ii uv <br /> _ npplicd for ond further a�recs to remove samc upon <br /> 4„30'�_ ._ _.__._..... . _ ....4.3�'.., notice irom the City and lo replaw public properry <br /> , <br /> damaqGd ihercl�// <br /> ,.�'?,'�1' L9u-C� �C�'.%----- <br /> Siynatui . o��.ppGcant <br /> COPY OF THIS APPLICATION TO ���`�`'0� v ' fI � / <br /> BE POSTED ON JOBSITE. �- L � '�``�'��--���"""��n <br /> Te�epbonc umbcr ���l <br /> CALL ENGINFERING DEPT.259•8811 `�'� ��' � T <br /> __O-.f.�_1__.'_._ '__--"___ <br /> 24 HqURS BEFORE CONSTRUCTION Oale <br /> — —�-- �-�,—�..7 — <br /> CHECK LIST Fce�/� v� <br /> Water Valvc Dept P�o 8I5 <br /> Drainage � � <br /> Curb&Guttor Engincers�_ _ - <br /> • Sidawalk Watr.r _ <br /> Strect --------_ ._---- <br /> C<�mmunicutions <br /> Inspector's Signaturc Tralfic_ — <br /> Planning___. <br /> �a1e <br /> Remarks <br /> Noce: ,r.hig+nal to Cusromer <br /> ,�oPY to F��e 10 9 9� — <br /> 1 Copy to Inspector Approved by <br /> n,... n............� . . <br />