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CV:reti <br />CITY ENGINEERS <br />EVERETT,WASHINGTON <br />The Undersigned YH(JL <br />Hereby applies for permission to <br />APPLICATION FOR RIGHT OF -WAY USE PERMIT <br />At the following location 7808 BEVERL Y BL VA <br />10225 <br />PERMIT NO. 7-5-10 7 <br />(Work to be done)\ <br />24' <br />150' \ <br />7808 <br />7� <br />GNRAG E <br />�EN/ CDNC <br />DRI VFv14 Y <br />fXI STING-CDN6RETf C/KP <br />ANO GUTTER: <br />DRIVEWAY SECTION <br />NO SCALE <br />I" LIP <br />-30 <br />COPY OF 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 & Gutter <br />Sidewalk <br />Inspector's Signature <br />'t <br />I — <br />Remarks <br />Note: Original to Customer <br />1 Copy to File 10225 <br />1 Copy to Inspector <br />The undersigned owner hereby agrees to hold and <br />save harmless the City of Everett from any and all <br />claims for damages that may arise because of installa- <br />4 i)? <br />tion and maintenance of the improvement hereto <br />( <br />applied for and further agrees to remove same upon <br />notic from the City and to replace public property <br />darpyged�there by. ..� <br />Signature of A(oplftahl �O Q gZp <br />l�, <br />SOo 1, tea p c .I 1. ucl— <br />D <br />Address <br />Telephone N-7umber <br />n 7 Date 7 S� <br />�L/ <br />/'/�. <br />Fee <br />L7 Approvals ! <br />Engineers <br />Water 2S <br />Street G <br />CommunicationS;7,4F-A� - G' 7.s <br />Traffic <br />/ <br />Plenning / /71 <br />,AMo <br />Date Al6proved <br />