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• APPLICATIO(� rOR RIG+-IT-OF•WAY I�SE PERMIT <br /> ' evered <br /> e <br /> CITY ENGINEERS PERMIT NO. <br /> EVERETT,WASHINGTON <br /> The Undersigned <br /> Hereby applies for permission to - . � <br /> , _ �� � <br /> At the foliowing location —� <br /> SKETCH <br /> (Work to be donel <br /> Se�7a� ` I L o� 1 � � , <br /> I <br /> � <br /> _ rJ' !_� . I <br /> �._.— - ; <br /> i � �i <br /> ,s ZO, , D ll <br /> a� <br /> � V .1 � aE <br /> i �� � 43 �� � ; . <br /> - _ _ _ -- _-�--- _--�- <br /> DRNEWAY SEC7i0N The undersigned owner hereby agrees to hold and <br /> NO SCA�E save harmless the Ciry of Evcrett from any and all <br /> __J claims for damages that may arise because of installa� <br /> r--- � tion and maintenance of the improvement hereto <br /> 1�" LiP -� appiied for and further agrees ta remove same upon <br /> �„3o",f�____—___.---- __—,.�,30"� notice from the Ciry and to replace pubiic property <br /> � damaged thereby. <br /> Signawre of Applicant _. _. <br /> ? �� ..� <br /> ._ --- ---. . ., Address ' — .. ' .... <br /> -- � ,� .'�.� � „ . <br /> COPY GF TI-IIS iIPPLICA�ION TO . . �r t�+ i_•�-_ <br /> B[ POSTED ON JOBSI iE. Telephone Number <br /> CALL [NGINEERING DEPT. 259�BA11 <br /> Date <br /> 24 HOURS REFORC CONSTRUCTION <br /> — ----- ------ . . — <br /> Fee <br /> CHECK LIST <br /> Water Valve Dept. Approvals <br /> Drainage Engineers � <br /> Curb&Gutter <br /> Sidewalk Water <br /> Street <br /> Communications <br /> Inspector's Sie�nature Traffic � <br /> Planning <br /> at-6 e-- <br /> Remarks � �. <br /> Approved by . � � , <br /> ` � f:� <br /> - n <br /> Datc ApProved <br />