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i� ,t <br />� �� <br />CITY ENGINEERS <br />E\�ERETT, WASHINGTON <br />The Undersigned . I � � <br />� <br />Herehy applies for permission to , <br />At the following <br />APPLICATION FOR RiGHT-OF-LNAY USE PERMIT <br />;' <br />��t' . <br />�' 1�'!f, <br />_ -��/;. �.�,•/, <br />.� �� J ..�. +_.. <br />PERMIT N0. <br />i. _ <br />� , <br />J - / <� .i <br />l /7 / �t ' l %/J. `v' l.'" 1 �' i �. <br />SKETCH <br />(Work to be done� _____ <br />IV 7J JL��L}� <br />I <br />T�LE'r'NON� ,gvX <br />N�cU �'DUC. 1� /;;U __ <br />—, � <br />UG ;1 <br />_ . -- <br />� <br />; ---- <br />I � <br />�/ ; �'' �i <br />� <br />I _. --- <br />i', I <br />�\ � <br />� � I <br />��.i,l � �� . <br />I <br />I _l, <br />� I �' I <br />DRIVEWAV SECTION j <br />NO SCALE <br />r-- --- _: -- -� <br />I" LIP <br />t�OT__--`_�/ ____ 30�1 <br />�,:�: �PY OF THIS APPLICl�1lON -�0 � � <br />:-�.� POSTEp ON JOBSITE. ' <br />�� l..l_ G���'�iP;Fl;RWG UEPT.259�E3fli � I <br />��_rri �_;rir,Fr_onisrrtucriori�l <br />CHECK LIST <br />Water Valve <br />Draina9e <br />Curb & Gutter <br />Sidewalk <br />� / , � f�/I� �!%'.l�b <br />I is •tor's Sign tA ure � <br />3-?-1� _ <br />Date <br />Remarks <br />Note: Oriyinal to Customer <br />� copy co Fl�e <br />1 Copy to Inspector <br />�, <br />I�;i�� t��� !.��U <br />i`J- :?v- �'� <br />=� <br />/$i <br />- / � <br />I I��� u (J U! I I. � � <br />�� _'�i� ,l, � �. <br />The undersigned owner hereby a;rees to hold and <br />sace harn.less the Ciry of Everstt irom any and all <br />claims for damages Ihat may arise because of install;r <br />[ion and maintenance of the improvemen[ herero <br />apPl�ed for and further a9rees to remove same upon <br />notic om the City ai -to replace public properry <br />dama d� ereby.. ���:� 7 �% <br />�'�.��C,r l�lc ---,�r�- <br />Signa[ure o Appli�cant — <br />1.� /� �!/t*�t ( �t �it.v Ci/��% <br />Address <br />'��5 �-77G0 <br />Telephone Number <br />� � / 7S" <br />Date ' <br />/-' _J> ,, f�/. //�i�/�., <br />Fee <br />� Dept.; Approvals <br />� <br />Engineersr`"�������/ ��/ //%J <br />L�Y,i�C.>r�. Water .� �� r �M-2 /i/70�J5 <br />Street,_;�j <br />CommunicaYo 6^�'y` -"`'�� �� �" "' <br />Traffic � � � � ' 0 � <br />Planning ✓ . � '�; l "��G'-- /U �- 7 \ � <br />•� � ^ � n — ,5� '; . <br />;>: � , <br />�— Approved liY Q % � �{--- i�� �n�_�; <br />�yc.t� .. � ���;-;.�r. �- Kf ���_vt�! <br />Date Approved � <br />