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�I <br /> APPLICATIQN FOR RIGHT-OF-WAY USE PERMIT <br /> � � • everett <br /> ' ' � 10736 <br /> � CITY ENGINEERS ' <br /> EVERETT,WASHiNGTON PERMITNO. ' � - `"� l� . <br /> The Undersigned � ' � <br /> Hereby applies for permizsion to � � " - � -.i , < /j „ � <br /> — I <br /> At the following location � �. " � � - �� <br /> SKETCH <br /> (Work to be done) � <br /> . _ .. i 1 ,. � . . . .. ; <br /> I <br /> i <br /> � <br /> � <br /> I <br /> i <br /> i <br /> i <br /> i <br /> i <br /> I I <br /> I <br /> I <br /> ! I <br /> ' i <br /> i <br /> i <br /> � � <br /> i <br /> � I <br /> i <br /> I <br /> � DRIVEwav SECnON The undersigned owner hereby agrees to hold and � <br /> �I {� NO SCaLE save harmless the Ciry of Everett from any and all � <br /> � I — �—"I claims for damayes that may arise because of installa� <br /> +p' Lip 71 tion and maintenance of the improvement hereto , <br /> applied ioc.and further agrees to remove same upon � <br /> 30" I �30"� notice from the City•3nd to replace puhlic property <br /> i —�t`— - <br /> �� da�x�ed therehy. � %� � <br /> . ` ._�, � , `' /.�"�� .r_'��� <br /> �- - '�I�': i / .� . <br /> � "Si�n"ature of Applicant 'i <br /> �" '� 1: i <br /> COPY UF THIS APPLICATION TO Address � � � ` ' ' <br /> �' BE POSTED ON JOBEITE .i �- : ,:, ,:,'�'<, �Y,r -- ' '�. <br /> r )_: \._ <br /> Telephone Number � <br /> CALL ENGINEERING DEPT. 259�BF1 7 - ' -'"7 C� <br /> 24 hIOURS L'EFORE CONSTRUCTIGPII Datt �, <br /> � _.. _ -_.__- - - - --- � - — .. . . . % J .� <br /> — : , — <br /> i, CHECK LIST Fee �, <br /> Wator Valve r Dept. Approval5 <br /> Drainage <br /> ' Curb&Gutter Engineers <br /> '�. Sidewalk �� i.. �� <br /> �� Water � . . <br /> ' .� //� - � � atree[ .. � � . . <br /> S Communic.tions . --� <br /> � Inspector's Signat�-^ � <br /> n Traffic ��. <br /> � l�/ � � — � 7 Planning_ . . <br /> G <br /> ate <br /> Remarks — . . �'�� <br /> Note: Ori�inal to Customcr <br /> 1 (:opy co Filc '} (��7? � � <br /> i <br /> 1 C�py to Inspec[or � � Approved by �, <br /> Date Apprnved <br />