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rorrru <br />e <br />CITV ENGINFf S:� <br />CVERET7. WASHINc. t�IN <br />The Undnrsiyned -- --.... <br />Hereby appGr,S inr permi55inn to <br />APPLIC.�TION FOR RIGHT-0F WAV USL P[RMIT <br />PERMI7 NU <br />1(l �E�,� <br />At the following location ' _., � _ _ ._ _._ <br />SKETCH <br />(Wnrk Io be dnnei <br />DRIVfW�V Sft.TIi.N <br />N�' S(.A� F <br />L.{i <br />L_�—_-�' I:IP _.___—� J <br />I 30�.. � . _ �!0'•I <br />�COhVOF 1NISFPPi;C/�Ii���'.: �. <br />BE POSTGD ON J�`)0SI I�F. <br />rni i I v�arart nin��� nrr � ��� ,, <br />, �. ... f�.f I Uhi. r!i^.� . � �. I iu��a <br />--_. __.._. <br />CHECK LI`T <br />Watei Vnloe <br />Dreina,�r <br />Curb & Gutter <br />Sidewalk <br />Inspectn�'s Signature <br />bate <br />�NR18fk 5 <br />No�e�. Original to Customer <br />1 Copy to File <br />1 Cnpy to InsPeclor <br />�n7�'2 <br />� I��� in.�Iri�,iqnrJ �iVnu,� hrmhy a�prr� iu holil I�n�l <br />sdvr hnmdcs� Ihe I:iIY u� f�.vcrnL' hurn any dnil .dl <br />claims for damages Ihal may anse ber.euse nl ur,t,iu.i <br />tion and maintenence of Uie improvement heirt�� <br />applied lor and funher agrees to remove same ui����� <br />notir.e from the City and to replace pubGc prop� ��� <br />damaged Ihereby. <br />Signalure of Applicent � - � � <br />� rl <br />Address <br />Telnphone Number + <br />Dete <br />Fee <br />Uept. Approvrils <br />En9ineers __ _ _ <br />Watei _ '. _ _ _. . _ . . . <br />Sireel__.___ '__�—__ . - :< <br />Communications <br />Traffic <br />Planning__ _ <br />Approved by <br />� .i �y.�,. , �. <br />