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i <br /> � APPLICATIQh FOR RIGHT•OF-WAY USE PERMIT �� 1 <br /> �everefl �� -- -� -- '� '�' <br /> � I-�c � �Ja � �`�'l� <br /> CI�TY EKGINEERS <br /> EVL=RETr,WqSHINGTON PERMIT NO. � <br /> The Unders�gned _ � <br /> Hereby applres for permission m - ' �� ;� <� �' " ' �� �-- <br /> - �--�` % <br /> At the foliowinq location ' �� � " � 1 ^. � <br /> i <br /> SKETCH _ —��� <br /> IWork to be donc� <br /> / <br /> DaIVEwAY SECTION The undr.rsigned owner hereby agrees to hold and <br /> NO SCALE save harmless the City of Everett from any and all <br /> f'---- --- — —� �-- -- - -� claims 1or damages that may arise because of installa• <br /> �'�., ��P tior and maintenance of the improvement herero <br /> applied for and further agrees to remove same upon <br /> � �„30'��—___ .y3�"�I notice irom the.City and to replace public property <br /> damaged thereby. <br /> SiGnature of Applicant 7�-,,,�, .r <br /> - - - - - � - - 4- �Tu...��t��.A�. I>r>,., , <br /> COPI' Of- TIi15 APPLICA i IUN TO � Address <br /> O[ POSTED ON JOBSITE. - � � � � � <br /> Telephone Number <br /> CALL ENGW[ERING DEPT. 259�f38i1 <br /> 24 HOURS 6EFORE CONSTRUCTION Date -� <br /> CHECK LIST Fec <br /> Wa�er vaive Dept. Approvals <br /> Drainage - - �� <br /> Curb &Guuer Engineeis_ ' �' i � :� <br /> Sidewalk Water <br /> Street <br /> Communicatiom�. <br /> Inspecinr'S Si��noture ' <br /> Tial(ic <br /> , <br /> Planning �� <br /> ate <br /> Remarks <br /> � _ . <br /> i <br /> Approved by � j � � � � <br /> Da1e APP�oved ` � <br /> . � <br />