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__ , n.. .. . ,,. <br />���N': I'.. . <br />' '�� APPI ICATION FOR RI(iHT-0E-WAV USE PERMIT <br />� � <br />CITY ENGINEERS <br />EVERETT.WASHINGTON <br />The Under.igned .1%r' ,'�� <br />Heroby epplies for permisslon to ._..�,';t�. <br />At the lollowfnp lacation��9 �5 <br />/ , �T i <br />IWork to be done) � " � � <br />,t� I /�S'/i<'�/ l. � / 4. %'/i . <br />�' � <br />DRIVEWAY SECTION <br />NO SCALE <br />{'—'---- ------ - --� <br />�I ----- <br />I \ 1� LIP <br />i-30-{-- ,--- .},ao„I <br />COPY OF THIS APPLICATION TO <br />BE POSTED ON J09SITE. <br />CALL ENGINEERING Df:PT. 259�8811 <br />74 HOURS DEFORE CONSTRUCTION <br />11329 <br />11329 <br />ITNO._)F�7 S 3 <br />The undersipned owner hereby prees to hold �nd <br />save hermless the City of Everett from any and all <br />claims for demages that may erise becw�e ot instelle• <br />tlon and meintenance of the Improvement heroto <br />applied for and further agrees to romove seme upon <br />notice Irom the Ciry and to replsce public properry <br />demaged thereby, i <br />; <br />' -� ; <br />Signe ure�o 1 plic I, <br />/%7 � � .��l` f'�i ("(� �i,.,,i <br />Addro <br />. , .. // <br />Telephone � umber � <br />� ��-��. <br />Date <br />Dept. Approvab <br />Enpineers_ <br />Warer ' <br />Street <br />Communications <br />Approved by . �. , - - - <br />INSP[i�TOR'S COPY DeteAppfoved Y <br />I <br />a <br />