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APPLICATION FOR RIGHT-OF-WAY USE PERMiT <br /> PYl`IPn <br /> � iu�y� <br /> CITY ENGINEERS �p <br /> EVERETT,WASHINCTON PERM!TNO. ��— ZV� �. <br /> The Undersigner:_s�„dt.lJ�� � ��J� //-��%l� � <br /> Ilereby applies fer permi:sion to �'1./�>�7,P 2.��� .��j�NiC)�,����/J <br /> At the following location__Si�si� �DTf� Qv�: ��� . <br /> SKETCH <br /> � (Work to be done) <br /> �� S%Y_ ly%%%9CI./�t� <br /> DRIVEWAY SFCTION The undersigned owner herehy agrees to hold and � I <br /> NO SCALE save hannless the City of Everet[irom any and all i , <br /> �-- ------ �-- -�-� claims for damages that may arise because of installa� ��� , <br /> +Y' LiP Jl [ion and maintenance of the improvement hcreto � <br /> applied for and further agrees to remove same upon ' <br /> �30'+_________�30" notice from !he Ciry and to replace public properry . <br /> damar,atl thereby�, � � <br /> �I .� / � �S Uc.' � �i <br /> ;, Signatur of A p icant <br /> COPY OF THIS APPLICATION l��� Address C ( �. � , J / <br /> � Bc POSTED ON JORSITE. . _^�r���—�7� -����-"�'-��-� `�•�ti <br /> � CALLENGWC-.ERIf.GDEPT. 25�JC:�.I '. 7elephoneNumber � ' � � <br /> �L �— /1 `!`9'�f <br /> � �� 74 tIOU^S fttFilRE CO�dSTRUCi IOP' Date '� <br /> _ _ ___ . ��- i�' �?'I ' <br /> i CHECK LIST Fee ::=' �� ' / ^,JT ,I <br /> Wator Valve 6ept. �1pp oval5 � <br /> Drainage „ „r'j�� �/'/ i <br /> Curb&Gutrer Engmeers l�/��u.-/� II <br /> Sidewalk Water <br /> Street i <br /> Communications _ <br /> Inspector's Signawre Traffic � <br /> Planning <br /> �te <br /> i <br /> Remarks <br /> Note: Original to Customer I <br /> , �oPY �o F��� 10999 ' <br /> 1 Copy to Inspector ApProved by I <br /> Date Approved <br />