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APPLICATION FOR RIGHT-UF•WAY USE PERMIT
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<br /> CITY ENGINEERS /'��/
<br /> EVERETT,WASHINGTON PERMIT N0.`�7l ��� ��
<br /> The Undersigned_`. � � � �
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<br /> Hereby applies for permission to"�
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<br /> At the following location � ' ��h � �� � '-
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<br /> DRiVEWAY SECTiON The undersigned owner hereby agrees to hold and
<br /> NO SCALE save harmless the City oi Everett from any and a�l
<br /> �_ _. -----� claims for damages that may arise because of installa�
<br /> tion and maintenance of the improvement hereto
<br /> �I" LIP apP��ed tor and further agrees to remove same upon
<br /> �_3o';,f� —T . . . _...�30�.., notice trom the City and to replace public properry �
<br /> ' � � damaged thereby. .�- . � . - -
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<br /> Signature o(Applicxnt � '
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<br /> - -� � Address .
<br /> � COPI' UF l HIS APPUC/�l IO�: TO ,- ii .;
<br /> i Bf POSTED ON JOL751TE. Te�ephone Number
<br /> �, CALL ENGINEERING DEPT. 259-IIf311 ' � �
<br /> �'�� ,�n HOUR; RFFOI;F CONSIf�Uf,TION �ate � � � �
<br /> CHECK LIST Fee .
<br /> water vaive Dept. Approvals
<br /> ' biainage
<br /> Curb&Gutter Engineers
<br /> Sidewalk Water
<br /> Street
<br /> Communications
<br /> Inspector's Signature Traftic
<br /> Planning
<br /> -�te ----
<br /> Remarks
<br /> Approved by
<br /> _ _ o
<br /> Date Approvcd
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