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'.—i�''—� Af'PLICATION FUR RIGIIT•OF-WAY USE PEHMIT <br />,.�.,.;,,�� . <br />t ' ��, <br />f- <br />CITY [NGINEERS <br />�V[RETT, N'ASNINGTON . ' <br />Thc UnJersigned _r1� I/1L� /� r% �('.�6(t�10_�-- <br />Flcrcby applics fnr permi;;icn to _�t✓_=7' � J�_Q <br />1107�: <br />PERN,IT N0. �7 '� <br />At tlie tollowin9 location �?i/ O�7f� DQ. S F � <br />SK[TCH . ' � , � <br />(Work to be done� � . - <br />sC� /-��AoNGi} <br />/,� �d Cdn,rT�u�'� <br />L� �� <br />z� <br />� 7� <br />DRIVEN'AY SECTION <br />NO SCALE <br />� � <br />Iil" LIP <br />�30;' �� . . _�.30•• <br />i <br />COPY OF THIS APPLICA7ION TO <br />BE POSTED ON-JOBSITE. <br />CALL ENG�NEERING DEPT. 259�8811 <br />24 HOURS BEFORE CnNsrR�1�TI0N <br />CHECK LIST <br />wamr valve <br />Draina9e <br />Curb & Guttcr <br />Sidewalk <br />Si9naturc <br />Notc: Orir�inal co Custorncr n <br />t Cnp�' lu F-ilc �_ 1'`J 7? <br />1 CaPY �� Inipccinr <br />The undcrsigned ownen c�reby a3rees to hold and <br />save harmless the City of Everett from any and all <br />claimi for damages that may arise hecause of installa- <br />tion and mainrenance of the improvement hereto <br />applicd for and further a9recs to remove same upon. �• <br />n ic\e from tLe City and to replace public properry'` '� . <br />da ay d thcreby/ <br />( r <br />/—J <br />Signaturero�plicant � <br />� 9� lO L�vir�.� .ci.–.%n 1�/� <br />Address - : y.�o 3 <br />.Z`5—�-77:Jz7 <br />Tcicphone Numbcr �� <br />/�—/(0`�7) <br />Date <br />Fee '�l � - � , <br />Dept. A��provals <br />En9inccrs � ? � !.�`� � _ <br />Watcr <br />L:ommunications <br />Tralfir �� . <br />f �Bp010g . . _ <br />Apprnved by <br />