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ki <br />APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />10574 <br />CITY ENGINEERS /� <br />EVERETT, WASHINGTON PERMIT N0. 710- ZOI <br />The Undersigned H r, r 1 i n L; n, I% f: A i rl <br />Hereby applies for permission to -on, t r ,, r f, PSI A <br />At the following location <br />SKETCH <br />(Work to be done) A <br />�ra � <br />l +k� PA <br />13 06 <br />P/� <br />DRIVEWAY SECTION <br />NO SCALE <br />Z If <br />1 \ /I" LIP <br />COPY OF THIS APPLICATION TO <br />BE POSTED ON JOBSITE. <br />CALL ENGINEERING DEPT. 2598811 <br />24 HOURS BEFORE ONSTRUCTION <br />Remarks <br />Note: Original to Customer <br />1 Copy to File 1 n 5 7 4 <br />1 Copy to Inspector <br />P/L <br />IN <br />L <br />r0 <br />va �c <br />U <br />'rvy, 9�1/74 <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 some upon <br />notice from the City and to replace public property <br />da((tpppnl11//AAged t reby. / <br />/��C/r A.- ./.�.. A <br />Signature of Applicant <br />.`a I—, / r u T i,- (JL S C t. e F1 <br />Address <br />3> j O�FsI <br />Telephone Number <br />Date�� Fee <br />Dept. Approvals <br />101eq.D I cf� Engineers ,-�Z����� 2(--a-41/ <br />Water�yi., U�'rMpPtfc'Lo r4�� <br />Street "c <br />Communications / ' <br />Traffic /A +:Yd t. Z /76 <br />Planning —rl—L—%A z,42og2 <br />50 n.crr / C; <br />Approved by <br />Date Approved <br />