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everett APPLICATION FOR RIGHT-OF-WAY USE PERMIT
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<br /> CITY ENGINEERS ��� _ �-'. —
<br /> �, EVERETf,WASHINGTON�-��\ % �-' �..�� ----�'
<br /> � PERMIT N0.
<br /> The Undersigned �t.r.t�! •-.:-
<br /> ! Hereby applies for permission to l � r ,�� >/'_ �'Y' ,�.�� � �
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<br /> I At the fr ,wing location=_! � � _ _.L..a� .�,'/ - - _ ��
<br /> � SKETCH I ,
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<br /> , �DRivEWaY SEc7i0N / The undersigned owner hereby agrees to hold and �
<br /> �, {�NO SCALE ;f.j� save harmless the City of Everett from any and all �
<br /> �� I Z�7 � '�,��;�� f�,F claims for damages that may arise because of installa• I
<br /> I 1 i" LIP �':� tion and maintenance of the improvement herero '
<br /> �I 30, �'— '��' ';. �f.� applied for and further agrees to remove same upon �i
<br /> . ��_ �30" ��1� .a t notice from the City and to re lace public property '
<br /> i � ,�t� , �t daJ�age thereby. • i
<br /> � ���� � �t � /�, � ��-. �'��_ �
<br /> ' ; ;, �l ature of Applicant
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<br /> � COPY OF THIS APPLICATION TO Address
<br /> �, BE POSTED ON JOBSITE. ?y�,'— O,� L c�/7c!j Z���Q' �
<br /> I CALL ENGINEERING DEPT. 259�8817 Telephone Number
<br /> �� -?—,P- 7C
<br /> . ?` -. ._____.-__. _.�------ --- Fee�/i •�_!, �-f��C' �i.1 � /,f/7 I
<br /> 1 HOURS C�E�ORE CONSTRUCTION Date I
<br /> CHECK LIST . �
<br /> � Water Valve ;
<br /> Drainage D pt. o Is �
<br /> ' Curb&Gut[er ��-11 -' '', � �
<br /> Sidewalk � � Engineer
<br /> Water , e G� I
<br /> �, � Street '
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<br /> � Communicatio `�i i
<br /> I ect r's ignature �
<br /> � Traffic �� !
<br /> ' n L —� .� Planning � _� ��
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<br /> Remarks '�,
<br /> � Note: Original to Customer ���
<br /> 1Copyrofile io�91 - �.
<br /> 1 Capy to Inspector Approved by �a ��
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<br /> Date Approved �
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