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evcrctt <br />e <br />('IlY [NGWFCH:i <br />EVERFTT, 1Nl15HINGTON <br />The Undcrsigned `� /� <br />Hereby applies lor pe�mission <br />APPLICATION FOR RIGHT-OF�WAY USE PERMIT <br />.� il�, � �!.%'�' �/' 77/.� i!_(, i .. . <br />At the tollowing location�}� %— %,SY4 � j, <br />(Work ta bc done) <br />�, <br />Q� <br />e <br />DRIVEWAY SECTION <br />� NO SCALE � <br />f� --�'' __ � <br />i^30,. � j�.� <br />6 <br />1n154 <br />PERMITNO. /� � � ��'�t <br />�i� <br />il/EI.J T7�EES(NOT TO <br />2D' REf1CH LC1 G+/ NANG//VC� <br />R1WER L/NE S� <br />TH ST. <br />I <br />� <br />74 7 <br />'1 `+ �. ' <br />� 7p / r07 I��Cl77 //cG3 OG�eI" ���lc�euic>' <br />�.� <br />�����ni iinr.;.rri_ic�iiuraru <br />i�os�i r�> oru .ioiisil� <br />�t L FNGINFERING DFPT. 259�A81 t I <br />�:��;�.rr���i�i r,���a��ii��ur,n��,�� <br />CHECK LIST <br />$idewalk <br />Z -�� -Z- �-� <br />a���• <br />Rrma�ks � <br />N��tr. O���ynal to Customr.r <br />I CuPy to File <br />� i������; ��� Ins�u�rt�n <br />� <br />���N <br />FN1 <br />��� <br />`� L!/rF /1� <br />r--i/�i%//V[�� li'��/�^'�/-iyJ <br />_ - .: .�,'�'.'` /� �3�GC� <br />�:; �( �.�.'lr_�'� �.J <br />The undersigneA owner hereby a�rees to hold anA <br />save harmless Ihe City of Everett from any and all <br />claims for Aamages that may a�ise because oi installa� <br />tion and maintenanr.e of qte improvement herelo <br />applied lor and further a�rees m remove snmr. upan <br />notice Rum the Ciry and to re lace ublic property / <br />dama9B/d/h� he�re6y.(j�✓:i fl �i--- �!A��AQ(' »{/w/` [� <br />_. _ikS1�31'���I�� % � .(/, <br />Signature oi Appli • <br />_ 7,�7__J�'._.i --��p/ -- <br />Addiess � <br />�-L._ �- _ _'Lr�h <br />Tr.lephonc NumbCt <br />_�'1�:�����. �!_��7rS-' <br />Date <br />N' � � ��= _ <br />� <br />Fec ._. . . ._.--- -- <br />ap Approvals <br />Engineers j"j�� �j�'����7� <br />�' Water—�-- --i/lL�16LZ -- . <br />i <br />$Veel�a��� __. <br />Communicutip � ��' _ �- �'� <br />Traffic_ _ _ __ . <br />Planni <br />n9- � _��� . . <br />� <br />1 �154 --- <br />�" APProve 6 ./ � <br />'�O` l.�(y�-�l/L�t� 4����/.. <br />Dalr�/1PProVec <br />