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APPL ICATION FOR RIGHT OF-WAY USE PERMIT <br />����vrn I i .:.� � �, + I nu <br />� ,M�1 II' <br />; <br />(�ITY fNGINLf R'; <br />FVERETT, WASHINGiON P( RMi! Nu _ _._ .__ <br />Thr Undert�gned . . _ _ _ . _ _. . -- — --- <br />NerebV aPPhes Im i+�: ���ission to _ -_. __ _ __ _ . —_ - _ — J <br />-�/,? �� . ¢ <br />�i the fallowing loca�inn_ -- -_--- <br />__ ._-- ._ __.__—. __ . _—_.__.—_— ______-. <br />SKETCH <br />IWork tn bi• dnnr� '� <br />� i <br />� � � -- <br />� ;� <br />;-�- _ � _ <br />i ,qsayH � % <br />0 <br />n�a�vrwnr sr�.noH <br />N SCA�E <br />;�, _ ,�� �,� _�'1 <br />.� '''' ..� � �.. � � . <br />�.��....:�n..i:� <br />f;llll 1-f�l!�IG (IEPT i59 R il I <br />� '��r��,rrii�-�.I���, <br />' CHECK LIST I <br />� w,nm vulve . - <br />U�ainnge <br />� Gub & Gutter <br />; S�drwalM <br />..s-J -..�� !� �; ,� i <br />Inspx_tot'cSignature r•" <br />// �, __ �/ � � <br />6ate -- <br />Rr�n�rkt <br />N����� � �� �qinal �o Custome� <br />���,,��� �,� �,�� 1(� � R 1 <br />� I ��li� li� li�'..i � I:�I <br />. .. <br />�, - <br />� . <br />, <br />Ihr imdieisiynrd �iwiiw hen,Ly :u�rnes Iu In�LI dnil <br />save harmless the C�ry of Evere!t from any and all <br />claims lor damages �hnt may arisr. beceuse of installa <br />tion end maintenence of the improvr.ment hr.reto <br />applird fnr and furUier agrees to remove samr. up�,n <br />nouce hnrn the Ciry end ro replece public proprrty <br />damagcA thereby. <br />a <br />-1.t�: �,_ _���� :� . <br />Sipneture oi �plicant <br />�r!�__im��_J�G �L <br />AAdr[is <br />1=- i_-1 YG U _ <br />Tulephone Number <br />Date -- - - — �------ <br />. . . i�n. � �« .! . , <br />Fer . � - �'l-�74' . <br />pt p ro Is <br />Enqme�{e ` � - ��%i�- <br />Wate� _ �aR Urr� e orSr�io �, ,. <br />� ��-----_.. . _. <br />Street_�r.�_,... _e <br />Ci�nmunic�fSons__ __ .. <br />TfAi�lf. // � <br />, <br />Plannin��� _.EIJ�.I�� . i:1 , . �• <br />Seor e � _ C�._�`.f Or-,pSr� __ /. ''. /• <br />Apprwed by/ �i �� ' � � <br />Y� . � . �/ . . � . <br />�I.11�. n'I�ili�i.��'�I <br />