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everett <br />e <br />�. <br />CITY ENGINEERS <br />EVERETT, WASHINGTON <br />APPLICATIQN FOR RIGHT-OF-WAY USE PERMIT , <br />10874 <br />PERMIT NO. 7 � � 7 � <br />The Undersigned �f�� t � ��' /v � � �� y �•'�� �� � ��/��� � `� <br />Hereby applies for pertnission to !�A ✓f � SS v L} CfJ �/ FD.{a/i Y1 ST I'�%''a 7'� I L rM1�s �` f� � <br />laSPi//i'L' lN (�On/JUN�T/OA/ V�� j'�L����'�� � 1�J�E�� <br />i <br />At the following location =� �� ��'� � <br />�i (Work to be done) <br />SY r <br />DRIVEWAY SECTION <br />NO SCALE � <br />r��- <br />� \ +I�� LIP <br />g` p�� � I _30"_ I <br />COPY OF THIS APPLICATION TO <br />BE POSTED ON JOBSITE. <br />CA�L ENGINEERING DEPT. 259�8811 <br />2S HOURS BEFORE CONSTflUCTI� <br />CHECK LIST <br />Water Valve <br />Drainage <br />Curb & Gutter <br />Sidewalk <br />� ' ��''� <br />I�Flector's Signature <br />,.—� —, --r i <br />� � �— � . <br />a[e <br />Remarks <br />Note: Original to Customer `, <br />, coPv ta Fi�e 1(1 O? 4 <br />1 Copy ta Inspector <br />1� j �/at.' !`f %17 <br />The undersi9ned owner hereby agrees to hold and <br />save harmless the City of Everett from any and all <br />claims for damages that may arise because of installa• <br />tion and maintenance of the improvement hereto <br />applied for and further agrees to remove same upon <br />notice from the City and to replace public property <br />c�amaged thereby. � � � ��� <br />U'i" � <br />Signature of Applicant i�.�r �j'���,,., <br />���',}'�- J�-c= <br />Address ,�. � . ,..(- , <br />����r��.,,�. �.,.....,_. <br />� � T.,L — �l / G � <br />Date <br />%- /- � % <br />Fee n/Q Fv � <br />Dept. Approvals <br />Engineers�n,.�D� --� <br />Communications <br />Approved by <br />Date Approved <br />