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APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />El <br />10248 <br />CITY ENGINEERS 7,5--/2�1 <br />EVI:3ETT, WASHINGTON //// T//'' f PERMIT N0. <br />The Undersigned_ C,P `� _ -I�1 <br />Hereby applies for permission to Co . l" ! .— �' /0 AP <br />--- <br />At the following location MR— <br />(Work to be done) <br />Nt°111 A01L. b/JI <br />L�I <br />1?`�NIICJ� CULVERT <br />NO CURS 6 aUTTBR <br />VAR. (2/U/ WIDTH <br />FDCE OF FA1ST1,V(_- R00b <br />DRIVEWAY SECTInN <br />NO SCALE <br />I I" LIP <br />f 0 I� —T501 <br />COPY OF THIS APPLICATION TO <br />BE POSTED ON JOBSITE. <br />CALL ENGINEERING DEPT. 259-8811 <br />24 HOURS BEFORE CONSTRUCTION <br />CHECK LIST <br />Water Valve <br />/ <br />Drainage <br />Curb & Gutter <br />S.dewalk <br />Y-� <br />I s ctol's Signature <br />The undersigned owner hereby agrees to hold and <br />save harmless the City of Everett from any and all <br />45 <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 />no ' from the City an to replace public property <br />a i.ged th eb <br />DRK B`i LM. <br />S g tur�e o~f�Ap�can. _ <br />3ex <br />7.3 a_ 75 <br />Y <br />Address <br />Telephone Number <br />Date �j� <br />jai-a-7 <br />7, so @ <br />Fee <br />AIDvals <br />p <br />Engin4&9 <br />Waterv..o _ 73/—Street <br />�,.,.,�, <br />_ <br />Common icatio <br />Traffic 1R1R � ii <br />'�— <br />Plannirjp:�� <br />Nrite: Original to Customer ^ Q <br />1 Copy to File j n 2 4 G ^ <br />1 Copy to Inspector ApP <br />,,ateApproved <br />