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APPLIC,aTION FOR RIGHi•OF•WAY USE PERMIT 1'�
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<br /> EVERETT, WASHIlvGTON PERMIT N0. -� �'` � -� ��
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<br /> D71VEW0.Y SECTION The undersigned owner hereby agrees[o hold and
<br /> � p w NO SCALE � — � � save harmless the Ciry of Everett from any and aiI
<br /> ^ - � 4 claims for damages that may arise hecause of installa�
<br /> ��I" LIP tion and maintenance of the improvement hereto
<br /> 30" _�p� Zn,__ applied for and funher agrees to remove same upon
<br /> �_„�,.__ I 30'� notice from the Cir/and tn replace public property
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<br /> damaged thereby.
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<br /> .'_'�PY OF THIS APPLICATIOW TO �' " - Addre'ss'
<br /> POSTC�i ON JOBSITE. . , i-_ ' -�.c.� �=t�U•a�FJl�O
<br /> �. i��;�LL ENGINEEflING DEPT.259�881 i I Telephone Number ^J- t rGU�_,
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<br /> � :'4 I�OURS BEFORE CONSTRUCTION� Date
<br /> CNECKLIST � � 1 1n IL/ 3����� -?� �
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<br /> Note: Original to C�stemPr �Y —
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