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APPLICATION FOR RIGHT-OF-WAY USE PERMIT
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<br /> CITY ENGINEERS �
<br /> EVERF."fl', WASHINGTON PERMIT N0. �F�, - ' •i�'�
<br /> The Undersigned •:'.`"� .. ,- "".-:t ����--• ,.� :..)
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<br /> Hereby apP�ies for permi:cion to�, ', �-��.� 1 r.. ' \ '�=, '
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<br /> At the following location_ n-�- - - `_^e;a:_,x�.,'�. �_,I ,+�� ., ;i . - -:,,`� .'�, ,�,�1
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<br /> DRIVEWAY SEC7i0N The undersi9ned o�,vner here�y agr=es to hold and
<br /> NO SCALE save harmless ttie(:i[��of Everett from any and all
<br /> �-?i�. � /.`,�,� � claims for damages that may arise because of installa�
<br /> ��� ��P tion and maintenance of tha improvement hereto �
<br /> applied fo, and further..yrees to remove same upon
<br /> �, 30" ,I� �v�;T�_ 30" . notice from the Ciry and [o replace public propert/
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<br /> clamaged thereby.. -� j -
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<br /> Signature of Applicant �
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<br /> �CJ?Y OF THIS APPLICATION TO Address ' ' �
<br /> POSTED OM1 JOBSITF. ' ^ "� - " -; � `i --
<br /> � Te�ephoie Number
<br /> �CALL EN�INEERING DEPT. 259-8811 .; .� , -� �
<br /> 4 HOURS EEFiIRE CONSTRUCTION Date '
<br /> CHECK LIST Fee � .
<br /> Water Valve Dept. Approval5 �
<br /> Drainage ,
<br /> Curb&Gutter Engineers �
<br /> Sidewalk Wnror
<br /> J SVice[ _
<br /> Comniunications
<br /> nsp cto�' Signature Traffic �
<br /> � � �iy Planning ,_._�
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<br /> at
<br /> Remarks �
<br /> 11234 _
<br /> Approved by �
<br /> ;`•�.�' Date Approved �
<br /> . IIJSPL'CTCR'S COPY �
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