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APPLICATION FOR HiGHT-OF-WAY USE PERMIT , <br />,- everett <br />, <br />CITY ENGINEERS <br />EVERETT, WASHINGTON <br />PERMIT NO. <br />The Undersigned A 1 6 e rf N, J O h n S o n _ <br />Hereby applies for permission to C 0 n S t r u r i o ?-I" .4 S rh D/Al <br />At the following location 9 5 1 7 = ~ AyP r 5 . E, <br />SKETCH <br />(Work to be done) <br />° Extend D/w to <br />rjl�S to m.,lch exi�tinJ e.1/0 pr.vrnj <br />PM:j <br />? �_ Asph. Qs01 <br />LPL\ <br />r S r- DE <br />Q:� <br />e � <br />p 61 S �r ev�Ac 12" <br />2 n� Q ti eur.., te,7ve,.r <br />2010I.-20 <br />' <br />— <br />�0, 1,70. 97' <br />P/ R.O.w. <br />DRIVEWAY SECTION <br />N6 SCALE <br />I" LIP <br />30" 30„ <br />COPY OF THIS APPLICATION TO <br />BE POSTED ON JOBSITE. <br />CALL ENGINEERING DEPT. 259-8811 <br />24 HOURS BEFORE CONSTRUCTION <br />i0 L. t/- (O <br />Date <br />Do Alot Sco le <br />10438�4. <br />�7 0 <br />The undersigned owner hereby agrees to hold and <br />save harmless the City of Everett from any and all <br />claims for damages that may arise because of installa- <br />tion and maintenance of the improvement hereto <br />applied for and further agrees to remove same upon <br />notice from the City and to replace ublic property <br />damaged thereby. <br />44't:i �-- <br />Si tiatur of ppllcan <br />Address <br />Ic7/ 3/ - <br />TelepTelepNumber <br />��� <br />DateTee <br />r� <br />/ B r5—c9 <br />De pro a e' <br />Engineers <br />Water U <br />7� <br />Street�1 ._ <br />Cornmunicatio s <br />,- <br />Traffic_ _ � �1..�- <br />41zo 17E <br />Planning <br />Secvu' —, C? <br />Remarks <br />Note: Original to Customer 1 Copy to File 10438 /// /��/'�,/—/�r <br />1 Copy to Inspector Approved by <br />Ipt U�Y Z/ <br />Date Approved <br />