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everen <br />CITY ENGINEERS <br />EVERETT, WASHINGTON <br />The Undersigned " <br />Hereby applies for permission to <br />APPLICATION FOR RIGHT.OF-WA`! USE PERMIT <br />2 <br />At the following Incatlon <br />SKETCH <br />(Work to tw done) <br />EKIs-r <br />Slue A%-te- <br />DRIVEWAY SECTION <br />NO SCALES <br />23 <br />I" LIP <br />11 <br />-3 <br />(.OPY CF THIS APPLICATION TO <br />BE POSTED ON JOBSITE. <br />CALL ENGINEERING DEPT. 259 8811 <br />24 HOURS BEFORE CONSTRUCTION <br />CHECK LIST <br />Water Valve <br />Drainage <br />Curb 8, Gutter <br />Sidewalk <br />?-� r)h t (� CdN7 Ili / <br />Inspeetor'sSignature <br />ate <br />Remarks <br />Note: Original to Customer 1 Copy to File 1 0 0'22 <br />1 Copy to Inspector <br />30-'Y <br />Rcd o <br />10022 <br />PERMIT NO. '/ 37 <br />The undersigned owner he,eby agrees to hold and <br />save harmless the City of E mrett from any and all <br />claims for damages that may arise because of installa. <br />tion and maintenance of the improvement hereto <br />applie and further agree.•• to remove same upon <br />no ' e fr t City to replace public property <br />m eb . <br />I ure of plicant <br />XI <br />Address <br />Telephon u >a <br />Date <br />Fee <br />// $O �a "�•%`/ <br />Appr� — <br />Da�pproved <br />it <br />