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— APPLICATION FOR RIGHT-0F UJl1Y L'SE PERMIT �,
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<br /> t.�iY F_NGWFERS
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<br /> Hereby epplies for permission to � .,n g f r .. r 1 f. JS ' .���b� /► n�.�_.'_c1__--_.__._ - ,
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<br /> At the follawing Iceation_.__ � !�o 2 O i S �� Q L t �• !.� —_
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<br /> t.0 vt .vn� r,� � .v .t�Y`S ! `.-� �� The u�dersiyned owncr here Y �Jrer.s lo hmd nn��
<br /> v� �,� n� r save harmless the Ciry ol Everett from any and .di
<br /> �� � � claims for dama9es tl�nl may arise 6ecauee ol ����.�.�c �
<br /> �- - - ,�,. i� � 7� tion an�+ maunenanre of the improveme�t hei�•���
<br /> . - � � - . „��pli�d fo� and further e9rr.es to remove samr w�� ,�.
<br /> _ �.. ... . ���n��e (rom Ihe Ciry anA to replar.e pul•lic piu�������
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<br /> '.�nnature of ApPlicant . . ._ _ ... -
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<br /> Telephone Number
<br /> �� I 1 NGi�•II f RIA1G fIEPT. ',"���!'���'i '
<br /> ,. . , � . ii:.���. iiu,.. Dete �, il� .
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<br /> CHECK UST Fee
<br /> v���in� Veive Dept. Approvals
<br /> � Oiainage
<br /> Curb &Gutter En9inners
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<br /> Communice�ti,opns/'���i•i��,�/ •�
<br /> i ��i�-��tn�'sSignature Traffic.�-.�........��iT�
<br /> Planning` __.
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