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CITY ENGINEERS <br />EVERETT, WAS14INGTON <br />The Undersigned LU FH, <br />Hereby applies for permission to <br />At the following location <br />SKETCH <br />(Work to be don ,K , <br />RR. <br />I1•1 A <br />APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />10323 <br />N Li11Lb L%_1`i ! LE <br />L U THE RAN CHI L D <br />CEN 7-F 2 <br />NtiA) OW <br />X15T1?JJ c00£ 17F <br />DRIVEWAY SECTION n/LI <br />NO SCALE <br />I" LIP <br />30" <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 />Drainage <br />Curb & Gutter _ <br />Sidewalk <br />r <br />ector's Signature <br />4- �s-7 C, <br />Date' <br />f 4.526 <br />ko <br />IVU/aL} <br />L_ LJ 13 ° ffu T TLI2 <br />WJN D K LI J U <br />1/-G-7S <br />Remarks <br />Note: Original to Customer <br />1Copy toFile 1.0323 <br />1 Copy to Inspector <br />PERMIT NO. ! ✓ — I // <br />4-S 2 6 <br />��- <br />z <br />2 <br />The undersigned 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 />applie for and further agrees to remove same upon <br />not a from the City d t replace public property <br />d a ed the Y. <br />ft� T <br />I, /• Sig ure of Applicant <br />Address 2 S$ I S 2 1 <br />Telephone Number <br />Date-4G�.C,Y.-� ,d.lr /•�!- /A//J�) <br />Fee <br />Communications <br />Date Ap roved <br />//—/a-7S <br />