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APPLICATION FQR RIGHT-QF-WAY USE PERMIT <br /> everetl <br /> � ,- <br /> CITY ENGINEERS �EflMff NO.____ —�- <br /> EVERETT,WASHINGTON <br /> The Undersigned --- — <br /> Hereby applies tor permission to_.__ — -- __ <br /> At tha following location ---- � � <br /> SKETCH <br /> (Work to be done) <br /> !_ . _._._...._..�..__�... <br /> The undersigned owner hereby �grees to hold and <br /> DRIVEWAV SECTION save harmless the City oi Everett from any and all <br /> NO SCALE � <br /> _. _ claims for dama9es that may arise because oi installa- <br /> I'�- � __ tion and maintenance o( the improvement hereto <br /> f' LIV �� applied tor and turther agrees to remove same upon <br /> �y�,�--�---- �j0"�,, notice trom the Ciry and to replace pu6lic properq� <br /> - dameged thereby. <br /> Signa:ure of Applicant � <br /> � Address <br /> ��COPY OF TH15 APPLICATION 10 � <br /> I6E POSTED ON J0t3SITE. i Te�ephone Number <br /> ICALL ENGINEERING DEPT. 259-8811 I Date <br /> 24 HOUflS �EFORE CONSTRUCTIUNi _ __ <br /> Fee <br /> CHECK LI57 Dept. Approvals <br /> Water Valve <br /> Drainage Engineers_.-- — <br /> Curb&Gutter <br /> SiAewalk Water <br /> "__. . -. . Street--— <br /> Communications__ <br /> .. . __. __. ._ ..---- - <br /> Inspector's Signawre Traffic <br /> Planning__ - <br /> .. - --_.__.._.__ - <br /> Bate <br /> .—__ _. .----- <br /> Remarks — <br /> Approved by <br /> -- _..—---� <br /> pare Approved n C <br /> � o <br />