5108 EVERGREEN WAY BASE FILE 2018-01-02 MF Import

i � -� . � � �% APPLICATION FOR RIGHT-OF•VlAY USE PERMIT � • everett 10 73 6 � I � � �� CITY ENGINEERS � ' EVERETT, WASHINGTON PERMITNO. ' -� ``� �� . � The Undersigned � - " �, Hereby applies for permission to � � � � + . � ; )J. . . At the following location - � - � i. , .� ,; �. I SKETCH � (Work to be done) � �� - : 1 - . ' � . � �� I � . . . . .� _ - . . � � I I � I i I i , � i � � I I i ! ; ' i � i i I I i IDRIVEWAY SECTION The undersigned owner hereby agrees ro hold and li , NG SCALE save harmless the City of Everett from any and all � f'— - � claims for damages that may arise 6ecause of installa� +i" LIP � tion and maintenance of the improvement hcreto , -- ' applied for,.and further agrees to remove same upon 3�I I 30' I notice,fom the City and to ieplate puhlic properry f"�' T—- ----�—+� � I i dart�aged there�� /,� i�' � � , � :/=.��;cf / TY -��_ ,. I 'Signature of Appl— c—Tant— . �J�� ,! y . � I COPY OF THIS APPLICATION TO Address � — ' I BE POSTED ON J06S:TE. .i �• ,� , -, � :��, �.,"h� �% ;i�; -', (-, ' CALL ENGINE[RING DEPT. 255-8817 Telephone Number 'i i : ,� 7�.-, , 24 HOURS BEFORF. CONSTRUCTION� Date I - - ' � �, CHECK LIST Fee � . , i, j Water Valve Dept. Approvals � Drainage . . , ��. Curb&Gutter Engineers ' ', Sidewalk � ' � Watcr_ �"� � _ �, � � .. ._ Street �� ' . , " ��_ � � _ Communications � '� �, Inspector s Signature � �. /� Traffic I ' li� .- � - 7 '7 P�anning ,�. , 0 ate �� Remarks - . � ' Notc: Original to Cusromer ' t Copy to Fiie '� (�7� � - '. 1 Co,�y to Inspector /�PP�.ov=�d bY � Date Approved �