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' APFLICATION FOR RIGHT-OF-WAY USE PERMIT <br /> evpren ^ ''7�� ; <br /> � e 1` r I' <br /> �� CITY ENGINEERS -; -�_ -� -, � <br /> EVERETT,WASHINGTON PERMITNO. � � � ` I <br /> �I The Undersigned �II <br /> I' Hereby applies for pertnission to -� � �� �t%��' ����� ' i <br /> I I <br /> . � <br /> �, At the following Ixation + � � / ' <br /> i <br /> � SKETCH I <br /> ' (Work to be done� � <br /> ; . � I . � � _ . � , <br /> �I � <br /> ' I <br /> i <br /> i <br /> � <br /> � <br /> I <br /> , <br /> � <br /> I � <br /> i I <br /> i ; <br /> i <br /> i � <br /> i i <br /> � <br /> . <br /> I. . � � <br /> � I <br /> � <br /> � <br /> � i <br /> ! I <br /> I <br /> � <br /> I \ DRIVEWAY SEC710N The undersigned owner hereby agrees to hold and , <br /> NO SCALE save harmless the City of Everett from any and ali � <br /> II� �.-- � claims for damages that may arise because of installa- , <br /> � i" LIP tion and maintenance of the improvement hereto , <br /> ! applied for and further agrees to remove same upon �, <br /> i 30" __ 3�" notice from the City and to repiace pub ic property �� <br /> 'I ge ereby. ^ ; <br /> --� ., _/. (�-�� . <br /> ; i ure of Applicant - I <br /> a �c! �--i S' 9 1�l � < �'� <br /> � � COPY OF THIS APPLICATION TO AdcJtess � <br /> ' BE P STED ON JOBSITE. `�'�� � �`'— �'I <br /> 'I Telep'hone Number / <br /> CAL ENGINEERING DEPT. 259�SS11 � ti s � k � " '' <br /> '� 2�9 H RS BEFORE CONSTRUCT�ONI Date ; <br /> -- --- t n <br /> CHEC LIST Fee � i <br /> Water Valve Dept. ApproValS <br /> '. Drainage '� <br /> I Curb&Gutter , .. , , Engineers . <br /> �� Sidewal , . . . � � � � Wa[er ' <br /> �� Street ��, <br /> ' Communications I <br /> � Inspector' Signature � Traffic � ' <br /> I Planning � <br /> � ate `"`"�" i <br /> Remarks <br /> , Note: Original toCustomer ' <br /> ' 7 Copy to File -� �-� �17� 2 � <br /> ' t Copy to Inspector � � Approved by . <br /> Date Approved � <br />