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APPIICATION FOR RIGHT-OF-WAY USE PERMIT <br /> �e 1os2a � <br /> CITV ENGINEERS �'t� !' <br /> EVERETT, WASHINGTON PERMIT ryu. � ' � ' �� �� �� <br /> TheUndersigned !�1 ' ,�i � 1 1 .�; `�� �� <br /> HerebY aPPlies inr permission m � ��:i �". �w.,�.� L ,� 1-� / % ' .��l:i �f r � ..i , <br /> At the fullowi�g location�,:f�j ��/��-�Lj"J��_���• '= � <br /> SKETCH <br /> (Work to be done) ��, <br /> "r.",- ;� 77,�Cr/..:`r� <br /> , <br /> � <br /> DRIVEWAY SECTiON The�ndersigned owner hereby agreeS to hold and ,. <br /> ; <br /> � NO SCn�€ save harmless the City of Everett from any and all <br /> �— -� ciaims for damages that may arise because of installa- <br /> �, i„ �iP tion and maintenance of the improvement hereto <br /> �� applied for and further agrees to remove same upon � <br /> '. 30" __�.__ 3�" notice from ffie City and to replace public property � <br /> , dam hereb� � � <br /> 9 APP` �' 7 S �v`. /� /� , I t, . i <br /> . �_. _-_. _. _ -__-____.__.t ' <br /> nature of licant <br /> � O . 1�,� 1 � �,', <br /> � COPY OF THiS APPLICATION TO ��� � Address I � <br /> ' BE POSTED ON JOBSITE � � 3' - �y'S- � <br /> �� CALL ENGINEERING DEPT. 2�59-8811I . Tele�;.honeNumber <br /> �'� 24 HOFIRS BEFORE CpNSTRUCTION! Date . ., � <br /> . I_-___ . _. __ _-__ _ . .. .. " ' ,f2-'�"� - <br /> �, CHECK LIST FEE , <br /> � Water Valve Dept. Appr�als ' <br /> Drainage /�y��y"/ /� <br /> Curb&Gutter � � �� � / ' Engineers y-,����� <br /> Sidewalk � Water . <br /> S[reet <br /> �� Communications <br /> Inspector's Signature TraXfic <br /> Planning_ <br /> at-6 e- --- �� <br /> Remarks <br /> Note: Original to Customer <br /> iCopytoFile � �;5j� 8 <br /> 7 Copy to Inspector � �� Apprevecl by <br /> Date Approved <br />