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APPLICATION FOR RIGHT-OF-WAY USE PERMIT 113 71 <br /> � everen <br /> � � <br /> CITY ENGINEERS <br /> EVERETT,WASHINGTON PERMIT NO, fr - �`7 Z. <br /> . - - - — � � <br /> The Undersigned �'i'�;�%�'-`'����.��',' .���1'� <br /> Hereby applies far permission to �:���'%L?4� � � � �.--'�- "�" '%%%f'�.'-��i ii;�%//�J^C� <br /> ,J / <br /> At the following Ixation - !�- = '� '� F> " � / � <br /> / <br /> St:ETCH <br /> (Work to be dooel <br /> 1� 121�/Fw�� lNS1AL�C �� <br /> � � <br /> DRIVEWAY SECTION The undersigned owner hereby agrees to hold and <br /> NO ScaLE save harmless the City of Everett fram any and all <br /> r— ----� claims for damages tha[may arise because of installa- <br /> +I" LIP �� tion and maintenance of the improvement hereto <br /> applied for and (urther agrees to remove same upon <br /> 3�r 3�� notice from the City and to replace public property <br /> �—�-- -----�- � <br /> damaged,ihereby. ! <br /> - - =� �^„' '!,'-'"/r'_..e'%'�� .i. <br /> Signature ot Applicant � � <br /> i:,' " :%J <br /> Address � <br /> COPV OF THIS APPLICATION TO ,. ;,. . _. �;J;;� „ <br /> BE POSTED ON JOBSITE. '�" . ' '�F'— <br /> TelepMne Number <br /> CALL ENGINEERING DEPT. 259�8811 <br /> . �24 HOURS OEFOftE CONSTRUCTION � Date � <br /> CHECK LIST Fee <br /> Water Valve DepT. Approvals <br /> Orainage <br /> Curb&Gutter Engineers <br /> Sidewalk Water � <br /> L ` Street_ <br /> Communications <br /> tor's Signature Traffic <br /> Planning <br /> � � 3 ��y � � <br /> ate <br /> � <br /> Remarks <br /> � 1371 <br /> ; <br /> Approvedby �._ ,� ���r.�] - ' �' . <br /> � :.. -7;�' i�,�P�l.�.� . � <br /> Da[e Approved�:' ' ,�� /� `� <br /> . � INSPECTOR'S COPY � _ '� , ;� /',. <br /> . , �,% - p �.;.". <br /> 1 <br />