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<br />� APPLICATION FOF RIGHT-CF-WAY US� PERMIT
<br />, everetl �� j'' C ' ..
<br /> I CITY ENGINEERS
<br /> EVERETT, WASHINGTON PERMIT N0._ '� "
<br />� TheUndersigned/!�':Ji���///�_%r/�i%J LOnJ �/._;�,(�.. ��i�� I��-v(. C I I�
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<br />' HerebyappliesTorpermissionto �l,Ar� �CA1i� �i�r1�.S O�Nr ��J1n! �`-)//���NC Oi�i l�/-'ecT/ �/�'�-��✓ �^//��T��
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<br /> At the following Iocation
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<br /> SKETCH
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<br /> � �RIVEwAY SECTION The undersigned owner hereby agrees to hold and
<br /> �. NO SCALE save harmless the Ciry of Everett from any and all
<br /> ' 1�-- -----� claims for damages that may arise because of installa-
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<br /> i" LIP l tion and maintenance of the improvement here[o
<br /> applied (or and turther agrees to remove same upon
<br /> � �,�30 7 30 noti rom th�e��,f ty and�To repla public�propey�y
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<br /> � Signatur f Applican
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<br /> /�1 ��r�s� �i_e=_/T /�_''v�'
<br /> �;OPY OF THIS APPUCATION TO ', Address
<br /> I';G POSTED ON JOBSITE. �j� l����
<br /> � Telephone Number �
<br /> .i,Li_ ENG�NEE�ING DFPT. 259-8?31 t ����7��
<br /> :.�-� IIOURS BEFOR[ C:ONSTRUCTI(1f�1�. Date
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<br /> CHECK LIST Fce ' •
<br /> wacer Vaive Dept. Approvals
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<br /> Drainage Engineers_ ' '7��-!��%<'� � �� ' 'Y�" ?
<br /> Curb&Gutter ... � ,
<br /> Sidewalk Water�'' " . �;�. �1�: .- ..;', :_i.�,__
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<br /> _ Ccmmunicatinns %�-�'.���"- ,�� �'�^��
<br /> inspector's Siynature Tratfic
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<br /> Rer�arks
<br /> ' Note: Original to Customer � ;
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<br /> 1 Copy ta Inspector Appraved by ��•. � i, � cl��� �
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