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cvcrett <br />� <br />CITY ENGINEERS <br />EVERETT,WASHINGTON <br />The Undersigned <br />/ <br />APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />e <br />for pennission to .G= �L T <br />� <br />= i�/ic <br />X <br />10 4 9 �� �v�F <br />, <br />� <br />G�� <br />PERMITNO. rL�— .`.Z� <br />/7 �� �-C'/✓�IZ.L=%L <br />,� n vTr/ /�,Pn.�'� �ii4'c_ <br />At the following loca[ion �' � Z � �"�'� ff cl L \�� <br />(Work to be done) <br />�.,.,. ,.,��t <br />� <br />'- ' i �/c <br />l� I `" <br />-� zdJ <br />� � <br />DRIVEWAY S�:CTI:.�V <br />NO SCALE <br />r x -----� <br />t I" LIP <br />�, �30'�— _.__ _—�.3-_'I <br />i , <br />i <br />IC�PY OF THIS APP�.ICATION TO ��. <br />B�= POSTED ON JOBSITE. I <br />! ('�^�LL EfJGINEFRIIVG DEP't'. 259-8811 i <br />i ; �ICURS ;iEFORC CONSTRUCTION� <br />Dra <br />I Sidewalk I � <br />/ <br />� <br />% �/ , <br />'' / <br />-��� `��/ � -/ ^v`.':�-. _. <br />Irispec[or's S�fiature � � <br />�ce ✓ '' Z % �� <br />/ � � �/�� > I <br />Remarks � <br />E.�;+rn j `�in� . <br />��,� , i._ . <br />Sh�f o!'F <br />No Scale <br />��i c/a/�c, <br />g529 <br />Wnic; ' d%' <br />!Y. O f :J, ��L <br />The undersigned owner hr.reby ayrees to hold and <br />save harmless the City of Everett from any and all <br />claims for damages thzt may arise because of installa- <br />tion and maintenance of the improvemen[ hereto <br />aoplied for and further agrees [o remove same upon <br />notice from the Ciry and to replace public property <br />dama e thereby. . . <br />�� � � - �.-_ <br />igi,4�u�e..bfApplican[ —� � <br />�S� 7 /� <_'• cfiAJ� /.cJ . <br />Address <br />�� 3 S ��� <br />Telephone Number <br />.: -- 2 '� - �� <br />Date <br />�D f,��. <br />Fee <br />� p,pr vals <br />Engineer / ��� <br />Wa[er �ua-� <br />Street �` . _� <br />Ccmmunicati� <--.--� <br />Traffic . � /� " G=� - � . ��p <br />Plannirtg � ' / � � <br />�,tw•?i�-- �.C. ��nAi PSo<, a��l�,� <br />Note: Ori�inal to Customer <br />1CopytoFile a.oays /f <br />1 Copy to Inspector Approved by °� � ,�/''_ �� /// <br />�-f:�l-�- /%' '•�.. <br />Date Approved <br />