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cvcrett <br />� <br />��� <br />CITY ENGINEERS <br />EVEiiETT, WASFIINGTON <br />APPLI... �TION FOR RIGHT-OF-WAY USE PERM;T <br />'.I''!iCi (l � " <br />�i . � i -!�! <br />`l � �i' <br />��i-._ � ...j <br />c�. <br />PERMIT N0. � _ <br />The Undersigned � ' � ` <br />Hcreby apG�ies for permis:ion to _ "' �� '=�'� — <br />At the following location <br />(Work to be done) <br />� ; .,.. _.' . ,_ ` . <br />/�;v'c:. !���;�/C �'� <br />DRIVEWAI' SEC710N <br />NO SCALE <br />'�' ------� <br />�.._. _ L :o <br />I" LIP I <br />�30 _f.—__ � _ �.30.1 <br />-r <br />L'GPY OF THIS APPLICATION TO <br />I'[ POSTED ON JOBSITE. <br />..'.LL �iJGINErRING DFPT. ?59-F,t! I ��. <br />:; eJ� :' i{EFOf i^,� d.,l �' i �._. <br />�) . � 7 . : '�. <br />� <br />Reinarks <br />Note: Ori9inal to Customer <br />i r,. Fip� <br />1 Cc;iy ta Inspcclor <br />, <br />, ' <br />� <br />� � �� <br />1,� ; <br />� <br />; <br />�A;�w, ;�>:.��,�,i�/ G;;✓� <br />�4rj;� <br />vr;;�„�c, <_y'���; ,. 'c <br />Thz 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 />[ion and maintenance oi the irt�provement hereto <br />applied for and further a9rees to remove same upon <br />notice `rom the Ciry and to replace public property <br />da/ma+ged thereby. � // / <br />l Jlfin.ii_i ,l� . � � ��.i'� <br />Signature of Applicant <br />_/> i` 1>�_� �i 7 %�a o j <br />Address <br />� <br />-3 ; �-( f"��n . <br />Telephone Number <br />�-/-�n-%� — <br />Date � <br />✓; %. " - i ��F � -�( <br />Fee <br />SEc✓v'i- /�/ C' '��a k�.�Sc > !��''� <br />,� �i � r. — <br />, . . • ApProved b � �� �/i <br />;�l_ :�,'�.,�- . ..�!� %/.�_ <br />Date A��prn�ed <br />