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APPLICATION FOR RIGHT-OF-WAY USE PERMIT �1312
<br /> everett
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<br /> CITY ENGINEERS S�- -7
<br /> EVERETT,YVASHIIJGTON PERMIT NO. �v z U /
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<br /> The Undersigned ' �� ' -� 4�
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<br /> Hereby applies for permission to . . ' '�� /
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<br /> At the following location �:� � 7 ,I^_ . —. • --� ^ �'��' �
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<br /> DRIVEWAY SECTION The undersigned owner hereby agrees to hold and
<br /> NO SCALE save harmless the City of Everett from any and all
<br /> � � � claims for damages that may arise because of installa-
<br /> I" LIP " tion and maintenance of the improvement hereto
<br /> applied for and further agrees to remove same upon
<br /> 30" _ 30� no+.ice from the City and to replace public property
<br /> damaged thereby-� / �
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<br /> � Signature of Ap ic8nf ' ` . '
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<br /> COPY OF THIS APPLICATION TO . Address �
<br /> BE POSTED ON J�BSITE. Telephone Nu bcr ; � � '4
<br /> CALL ENGINEERING DEPT. 259�8811 y _ / _ j ��
<br /> 24 HOURS BEFORE CONSTRUCTIO� Date �
<br /> CHECK LIST Fee `�� � :� ��i� ,;:1.;, .�� f.:; Z7 �,� ,'- �J -
<br /> Water Valve Dept. Approvals //7�
<br /> Drainage
<br /> Curb&Gutter Engineers
<br /> Sidewalk Water
<br /> � Street
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<br /> G� � / Communications
<br /> Ir.spector's Signature 4 Treffic
<br /> �� �� Planniny
<br /> ate
<br /> Remarks
<br /> 11312 --- �—
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<br /> Approved by ;'� „` � *^'"� ..
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<br /> � Date Approved� ' � .
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