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i'vurett <br />� <br />CITV ENGINEERS <br />EVERETT, Wl1SHIN(iTON <br />APPL�CATION FOR RIGHT�OF-WAY USE PERMIT <br />The Undcrsigned � � � � _' ��t �',�i <br />Hareby applies hr permission to �_� � <br />At the following location__,-i � _ <br />SKETCII <br />(IVork t�� be done) <br />DHNEWAY SECTION <br />NO SCn _E <br />r- � <br />i <br />��1„ LIP ______� <br />�30.� j—__.._ _ -- �30"� <br />���P1' Oh THIS I�PPLII:AI IUN IU <br />� I POSTED ON JOBS�TE. <br />�'l�l L f VJ�,IrJ! CNING DEPT. 259 tilSi i <br />.'A Ili7liH6 I,I I I�i,l CONSTRUf:11UfJ <br />CHECK LIST � <br />Weter Valve <br />Orainege <br />Curh & Gutter <br />SiAewalk <br />Inspector's SignaWre <br />Ua�e <br />Hnmarks <br />�Iqir: Origin;d to C,u:tomm (� <br />1 Cu�ry In I dc � 1 J� � r <br />1 i��ipy o� liiy���� n�i <br />a/ I <br />�� � <br />� � Y / <br />__ � _(:!/�� � /� <br />�� _ <br />0 <br />' �715 <br />i '� z <br />PERMIT NO. ' ' <br />, . �.. .. ; I ;; . r,-.:l <br />l!U�, I..�1 . {.'1��. y.IJ::/Jn .ri��Ch � <br />� �. (h� b,rr�.d ' <br />lv fl vt. /��'t �1.�✓♦SC <br />t�..i.. ��Vr�rl � � ��iC C �� /i <br />, ./f ; , .7l.6r '/..�t:f , <br />th� <br />• � 5%r � <br />(h. <br />� r ,�/ .� <br />The undeisiqned ownP.r hereby agrees to hold nnd <br />save harmless the City of Eveiett from any and all <br />claims for damayrs thn� may arise becxuse nl installa� <br />lirn� anA maintenance ol the impiovement hereto <br />applie�l jQr anA further agrees to remove same upon <br />notice_ti6m the Ciry and to reulace puhlic proprny <br />�plicant <br />�i��� '.T NL :4A, <br />. ..._.'�7 1 �� ' }j '7� 7 �, <br />Telephone Number �- <br />'�,/-�--i.L( �-- � - <br />Date n �, <br />—�_{ � � _�.�h � ... . _ . . <br />Fee <br />Dept. Appjovals <br />[ngineers ��_l.__,[�_.L-f,'S1S:-,— - - --- <br />Water � � � _i . . .. <br />Siree� � �7� - , r ' . > _ G.�,. , io- ,. <br />Communications_ _ <br />. � ' � n � � ���isz,�.. ..l� : ..., _�.. <br />� N . .. e � <br />,. , . . ., � i i. � tJ'.i�,.� %u��.��7/ � ..� s. <br />Apprmed bY. <br />Dalc APPruved <br />