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�-[' ' . <br /> everett APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br /> . e - so736 <br /> CITY ENGINEERS �/ �: <br /> EVERETT, WASHINGTON PERMIT N0._� 7'� 7 _�� , �. <br /> � The Undersigned l;�.r l.�,� %; ;a ;��.i ;.�* j <br /> Hereby applies for permission ro r� �� ; 7- - 9 � s � � � I <br /> � At the following location �:/D Sr �C ii.;?�',";�,rJ i �,i �,/ <br /> SKETCH i <br /> (Work to be done) . � � <br /> � s _/' ._ �a j j/dC/a�s;, <br /> I <br /> ' � � � <br /> , <br /> i <br /> i <br /> � � <br /> i <br /> , <br /> ; DRIVEWAY SECTION Thc undersigned owner h�reby agrees [o hold and � I <br /> � NO SCALE save harmless the City of Everett from any and all � <br /> . � --� . ciaims for damages that may arise because of installa• � <br /> i f' LIP tion and maintenance of the improvement hcreto , <br /> � apPlied for nd further agrees to re nove same upon � <br /> , 30'—� ___ I .30" notice f m the City nd to rep a e pub iC property � <br /> -'T` <br /> m d there <br /> � � ignawre of Applic nt — � <br /> __ '-- O �ok' 7 <br /> . COPY OF THIS APPLICATION TO Addr.ss � �n � 3 � <br /> BE POSTED ON JOBSITE. i/�� ��� � <br /> � Tele ione Number <br /> CALL ENGINEERING DEPT. 259�8811 7�—�,���� <br /> 24 FIOURS QEFORE CONSTRUCTION� Date J _ 8 _ 7> � <br /> - - . ._---- - -..._ - � <br /> . CHECK LIST Fee �� ' i — '�. - <br /> Water Valve �p'- ��i�i � <br /> Dept. Approvals <br /> Drainage ' <br /> � Curb & Gutter Engineers S'� � �'�s � II . <br /> � Sidcwalk . Water �i.�?� �� - �n� ���-.��� I <br /> . 5 r - r� G��: Strcet �'�S'.'� � . . <br /> 'r � S�i I,L7 � <br /> � Communica[ions - �� <br /> Inspector'sSignature � Traffic � ; <br /> � - Plannin9 �� <br /> ' �te ���' ..n :�l . � � � e .�i.�/'-c] �...� <br /> � Rema�ks � �- .. -� � <br /> Note: Original to Customer . <br /> . 1 CopY to Filc '��7� 6' �. <br /> � 1 Copy to Inspecror Approved by . <br /> � Datc Approved ' <br />