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" APPLICATION FOR RIGHT-OFWAY USE PERMIT <br /> �e <br /> ,�825�` <br /> � <br /> CITV ENGINEERS � +""�-. <br /> � <br /> EVERETT, WASHINGTON PERMIT i � <. <br /> The Undersigned <br /> Here6y applies for permission to � �� � _ ( J � ,-� ,.•;� .�� - �'�/ ,.• � <br /> At the following location =-� �-<: ..# J�.}.�j� j - �p .T. s`� � <br /> SKETCH <br /> (Work to be done) <br /> > r.� ;.� - : .t� ,,,,� <br /> � <br /> ; <br /> '� DRIVEWAv SECT!ON The undersigned owner here!by agrees to hold and <br /> �- , NO ScaLe save harmless the City of Everett from any aod all . <br /> � �� claims for�+amages that may arise because of installa- <br /> ' f' uP tion and maintenance of ffie improvement hereto <br /> ���., 30" _ __ 3p�� applied for and turther agrees to remove same upon �� <br /> , notice from the City and to replace public preperty <br /> . �. damypql�ereby� O� . <br /> Y% ,�t i <br /> I 5'ignature of Applicant � <br /> COPY OF THIS APPLICATION�TO �d�ress---��� � � ��� '� �� ' <br /> �. BE POSTED ON JOBSITE. '� j �_ �� �� <br /> ��, CALLENGINEERWGDEPT. 25&8817 TelephoneNumber � <br /> . 24 HOUqS BEFORE CONSTRUCTION� . Date �_. � � <br /> - � r <br /> �. CHECK UST Fee � � <br /> Water Valve � <br /> � Dr'dinage _/ ��� � 9 ��aW-c2 P.fQ1J8�3 <br /> Curb&Gutter �� r l+ //d <br /> �� Sidewalk �`� En ineers �./ <br /> Water <br /> Street <br /> Communicatiorts <br /> Inspector's S�gnamre . . <br /> Traffic <br /> Planning <br /> ate <br /> Remarks — <br /> Note: Original to Customer <br /> iCopytoFile 10�25 - <br /> 1 Copy to Inspector Approved by <br /> Date Approved <br />