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ever8tt <br />CITY ENGINEERS <br />EVERETT, WASHINGTON <br />The Undersigned _ <br />Hereby applies for <br />APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />11033 <br />-� <br />PERMIT NO. 3 Z <br />to <br />At the following location _S (CD_C7- A 7 rL Fni v,1.in n uJ; <br />SKETCH <br />(Work to be done) <br />DRIVEWAY SECTION <br />NO SCALE <br />+I" LIP <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 />Inspector's Signature <br />Remarks <br />Note: Original to Customer <br />1 Copy to File 11033 <br />1 Copy to Inspector <br />SEE ijTTl4GHaJ <br />The undersigned owner hereby agrees to hold and <br />save harmless the City of Everett from any and all <br />claims for darges that may arise because of installa. <br />tion and main enance of the improvement hereto <br />applied fora further agrees to remove s me upon <br />notice frol� a City and to replajpub�property <br />one <br />Date -Ol" n <br />Fee <br />Dept. Approvals <br />Street <br />Communications <br />Approved by <br />Date Approved <br />