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APPLICATION FOR RIGtiT-OF-WAY USE PERMIT <br /> ��.0� .1. :� / �'C' <br /> CITY ENGINEERS <br /> EVERETT, WASHINGTON PERMITNO. � � � <br /> The Undersigned " ," / - ri '. - — " <br /> Hereby applies for permission to � � + c ` i," � i� 5 .�-i � ,� <br /> At the following location =- :� � 1 :� �= `; j <br /> SKGTCH -- <br /> '`... (Work ro be done� <br /> DqIVEWAY SECTION The undcrsigned owner hereby agrees to hold and <br /> {� NO SCALF. save harmless the City of Everett from any and all <br /> I ---- � '� claims for damages that may arise because of installa- <br /> +I" LIP �� tion and maintenance of the improvement hereto � <br /> � � I applied for and fur[her agrees to remove same upon <br /> Y'-0'�'__��— __---�Y30"� notice from the Ciry and [o replace public properry <br /> dary ed thereby.�(� .. � <br /> ��-� i"Lf,/,cCi - .� j� �- <br /> Sig atureof,Applicant '/�'"�— .,_�- <br /> 1�rz�11 '��_ <br /> +COPY OF THIS APPLICATION TO �� Add s �, _ <br /> i <br /> BE POSTED ON JORSITE. . �.��:- �. � �.s ��� r{yo?��-- <br /> Telephone Number <br /> CALL ENGIfdEERING DEPT. 259�881 �� �`�.: y��/ <br /> 24 HOURS BEFOR� CO�STRUCTI�i�' Date � � <br /> -- - - / 'L � � �, �. <br /> CHECK LIST Fee —' <br /> Wacer Vaive Dept. Approvals <br /> Drainage <br /> Curb & Gutter Engineers��i�"��;—_ � <br /> Sidewalk ' <br /> Water .o��. _.:�_. �9v,._ _. : �� w�.� <br /> �L --7 <br /> P� Street �'� ��� , <br /> �_C��jG��- Communications <br /> —tnspecmr's SignaW ra Treffic <br /> �� � � .— � � Planning <br /> fJate � .�+t... . /�.r:,..., �, . �., G: <br /> � <br /> Remarks <br /> � <br /> Notc: Onginal to Customer <br /> 1 Copy to File ��� � — <br /> 1 Copy tn losper.tnr �� � � Approved by� <br /> C <br /> ---�_ _____—._...__.__ <br /> Udte Approved . � ... � . _ . <br />