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[,-I, <br />verett <br />CITY ENGINL"ERS <br />EVERETT,WASHINGTON <br />.,IrLJI.:,IWNi-ORitIGHT-OF-WAYUbtl'thIVIIf Iiiy0 <br />PERMITNO.Jg / 01 _ <br />The Undersigned _ ILRU/U \A/. LA/, <br />Hereby applies for permission to \/✓/D6/✓ FX/ST,.vr_ J;/�!_fp <br />/V/O' <br />At the following location /•ilD.� �6 �/� S i <br />SKETCH Chee! <br />(Work to be done) (i) d/W r,.od.r'x <br />4-1-4.7 f <br />M <br />�.xISTIto 6 <br />FFS, <br />(UT+! 'SiRGS -r <br />er---- 15 / —9 <br />r'LANM :-o <br />S <br />i I <br />DRIVEWAY SECTION <br />,' NO SCALE <br />i <br />3� 130" II <br />COPY OF THIS APPLICATION TO <br />BE POSTED ON JOBSITE. <br />CALL ENGINEERING DEPT.259-8811 <br />24 HOURS BEFORE CONSTRUCTION <br />CHECK LIST <br />Water Valve <br />Drainage <br />Curb & Gutter <br />Sidewalk <br />1 _ _ <br />Inspector's Signature <br />Remarks 11190 <br />The undersigned owner hereby agrees to hold and <br />save harmless the City of Everett from any and all <br />claims for damages that may arise because of installa• <br />tion and maintenance of the improvement hereto <br />applied for and further agrees to remove same upon <br />notice from the City and to replace public property <br />da�n\aged thereby. <br />Signature of Applicant <br />Address <br />Telephone Number <br />`1- 7•-r-79 <br />Date <br />Dept. Approvals <br />Engineers,. <br />Water__ <br />Communications <br />Traffic__. __-_ <br />Approved by <br />