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evcren APPLIC..TION FOR RIGHT-OF•WAY USE PEHMIT � ._ j � �• <br /> I � <br /> CITY ENGINEERS �/ ` C <br /> EVERETT,WASHINGTON PERMIT N0. <br /> Tne Undersigned <br /> Hereby applies tor permission to _ <br /> At ihe following location _ �__,___._____. _ __ <br /> SKETCH <br /> (Work to be done) <br /> DRIVE:WAY SECTION The uncle�signed owner hereby agrees to hold and <br /> NU Sca�E save harmless the Ciry ol Eveieu from any and all <br /> f" - -� - � ��� - �-� -- - - -"j claims lo�damages that may arise because of installa� <br /> (� �, ��P -_�� tion and maintenance of the improvement hareto <br /> L��--= applied for and turthcr egrees to remove seme upon <br /> 4„3o'y—�� �„3n"�; notice from the City end m replace public properry . <br /> damaped there6y. � '- - <br /> Signeture ot Applicant <br /> � COPV OF THIS �PPIJCAiION lU � Address <br /> I !iF POSTED ON JOBSITE. I <br /> ''� (:i1LL LNGIf�EE(iING DfPT. 259�8N11 � Telephone Numt�er . <br /> I74 HOUHi BLFORF CONSTRUC1lUV I �'1te <br /> CHECK LIST Fee <br /> waier vaive— Dept. Approvals <br /> Drainage <br /> Curb&Gutter Engineers_ <br /> Sidewalk Water <br /> Strcet <br /> Communications <br /> Insper.tor's Signature <br /> Traftic <br /> Plenning _ <br /> �ate ------------------- _ <br /> Remarks <br /> Approvecl by <br /> Date Approved � <br />