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�����n) <br />� <br />CITY ENG�NEERS <br />EVERETT,WASHINGTON <br />The Undersigned _ <br />Hereby applies for permission to <br />At the tollowing location_ <br />SKETCH <br />IWork to bc done� <br />�� <br />APPLICATION FOR RIGHT-OF•WAY USE PERMIT <br />�HIVEWAY SEC7i0N <br />NO SCALE <br />�--��-�-------- ._. . _ I <br />�_ ��•� LIP � <br />I,,,30 M—� . �70 -. <br />COPY Of- Th115 APPLICATION 10 �' <br />BE POSTED ON JO�SITE � <br />CALL ENGIN[ERING DEPT. 259�8811 i <br />i 24 HOURS BEFOH[ CONSTRUCTION'I <br />CHECK LIST <br />Water Valve <br />Drainage <br />Curb & Gutter <br />Sid�walk _ <br />Inspector's Signamre <br />6ate -- <br />R�marks <br />PERMIT NO. <br />The undersigned ,wner herr.by a9rees to hold and <br />save harmless ihe City of Everett from any and all <br />claims for damages that may arise because of installa� <br />tion and maintenance of the improvement hereto <br />aoplied for and further agrees to remove s�me upon <br />notir.e from Nie Ci�y and to replace pu6lic properry <br />damaged thereby. <br />Signawre of Applicant <br />Telephone Number — <br />- l�E�PJ <br />o��� �� �����D <br />Fee �/2��J � <br />Dept. Approvals <br />Enqir�e�rs___ <br />Ccmmunications <br />Planning. <br />ApProved by <br />Date Approved <br />0 <br />� <br />