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- everen <br />e <br />CITY ENGINEERS <br />EVERETT, WASHINGTON <br />APPLICATION FOR RIGHT-OF•WAY USE PERMIT <br />� � • i <br />. <br />-' - � <br />PERYIITNO. -".L.� <br />The Undersigned r�' � - � � % <br />Hereby applies for pertnission to � -:.i ' T �" � - .- r1 �• �; � ,f !�.•��,� ; -� �� %�i � <br />At the tollowing Iceation - � <br />SKETCH <br />(Work to be donc) <br />DRIVEWAY SECTION <br />NO SCALE <br />r- ----- - -� <br />_i I" LIP � <br />�3o'i'___ _� .._—_— _�.30 ,� <br />CO'�'Y 0� THIS APPLICATION TO � <br />6E POSTGD ON J06SITE. <br />CA�L ENGIN[ERING DEPT. 259�8811 � <br />� 24 H011H5 [�EFOR[ CONS?-RUCI IOiV'. <br />CHECK LIST <br />Water Valve <br />Drainage <br />Curb & Guttr,r <br />Sidewalk <br />Inspector's Signanire <br />L� <br />The undersigned owner hereby agrees to hold and <br />save liarmless the City of Everett irom any and all <br />claims (or damages that may arise because of installa� <br />tion and maintenance of the improvement hereto <br />applied for and further agrees to remove same upon <br />notice from the City and to replace public property <br />damaged thereby, <br />i , - a,� <br />�S;gnature oi Applicant � <br />= � 1 i,i��-_ �.,,_.-� �. <br />,4ddress <br />- I �� <br />Telechune Number <br />'•� . � j <br />Date , � <br />' � � � .! <br />Fee <br />Dept. Approvals <br />. � <br />Engineors_':� �a- � <br />Communications__. <br />Note: Original to Customer . <br />��. <br />, co�Y �o F,�� 1 f1 � � � , <br />i Copy to Inspector � . ApprovEtl 41 � �', <br />� _ , �Si .� i��"._� ^'1 <br />'^— � / <br />Uate Approved � <br />