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APPLICATION F7R RIGHT-OF-WAY USE PERMIT <br />everetl <br />� <br />CITY ENGINEERS <br />EVERETT WASHINGTON <br />The Undersigned _ ' -��� " � <br />Here6yappliesforpermissionto` '-����/r��� ���� � -�� ' �'- <br />At the following I <br />SKETCH <br />(Work to be done) <br />Dr7iVEK'AY SECTION <br />NO SCALE <br />�— l5, __ _ �{ <br />� I'� LIP <br />30" _. ._._-_ .___ I 30" I <br />_.�. ^� <br />-� ' <br />. ..i'✓':i:� � :`.�. ._. <br />i. <br />O1 <br />j COPV OF THIS APPLICATION TO ��i <br />'� BE POSTED ON JOBSITE. ' <br />��, C/1�L ENGINE�RING DEPT. 259-8871 I <br />, �{n�ii, ^,���03E COF�'iPLiCnO�l= <br />� _ � — � G�L�i ° l�� <br />CHECK LIST <br />Water Valve <br />Drainage <br />Curb & Gutter <br />Sidewalk <br />_����' ., _ • <br />; ,; ;-, ; r� : ,, - <br />I nSpector's 5 igr�� tu re <br />' j � � _. <br />—o�«' <br />, <br />'� -;, , - jlv� <.�s✓, <br />�.:-; . . <br />n�,�„��ks <br />Notc: Oriyinal to Customer <br />1 Capy in File 'j (i, /� f; 7 <br />I Copy to Inspector .. . - - <br />PERMIT <br />l <br />_. U :(! u. � <br />. /L'? <br />�� <br />„ —,l C - <br />92 "'o �; s c <br />The undersigned owner hereby a�rees to hold and <br />save harmless the City of Evere[[ from any and all <br />claims foi damages that may arise 6ecause of ins[alla- <br />tion and maintenance of the improvement hereto <br />applied F- and further agrees to remove same upon <br />notice fro:n the City and to replace public property <br />damaged thereby. �/ � �� <br />-i „ 'a:-s= -_y� � <br />Signa[ure�o� p ican[ <br />� i� L�J� �'7G i �/-�' _ n �_ <br />iid�f¢55 <br />� �- o / =-�, � <br />Telephone Numher <br />l/ � i�� , .. : / <br />Date / <br />� _ _ =r:��— l . _ � 7f. <br />Fee <br />De t. A roval <br />Engineer,s--' � T /� <br />Water a,��-�w�Lf.'cc-,Fta �.�';��", <br />Approved�Y.� G� / <br />' / i '! ' <br />__ "/,.,_�/. <br />D'JIL H�I�IIOVC� <br />�s�� <br />