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everett APPLICATION fOR RIGH7-OF-WAY USE PERMIT <br /> 11292 <br /> CITY ENGINEERS <br /> EVERETT,WASHINGTON PERMIT N0. ' �> � � � i 7 <br /> The Undersigned_ _ ;.� -, �- ` � �,i,-_ 1 ��nr :, �� _. . <br /> Hereby applies for pertnission to "—:( ���7 i , ,�, - _ _ <br /> ' � - - - 1 �: l i r- 1 <br /> At the fotlowin location � ' <br /> 9 �� , r-y � �-7��- I <br /> � <br /> i <br /> SKETCH <br /> (Work to be done) __ � —( <br /> .a. <br /> ��_�_ <br /> / q�I' 'rlAL.7 _ _ - <br /> k'�YE. <br /> L Kf V�W.a.�. <br /> � !._i_.I C��—f-- �.�fQ�: <br /> DRIVEWAY SECTION The undersigned owner hereby agrees to hold and <br /> , NO SCALE save harmiess the City of Everett from any and all <br /> � -� claims for damayes that may arise because of installa- <br /> �� 1�" �iP �-7� tion and maintenance of the improvement hereto <br /> 30" _ ______�3p� applied for and further agrees to remove same upon <br /> notice from the City and to replace public property <br /> damaged thereby. <br /> .,.f r / <br /> Signa�ta're o PPlicanN - <br /> . . ii..., ..: �� i\� — <br /> COPY OF THIS APPLICATION TO Address ���C <br /> BE POSTF.D ON JOBSITE. � - --_ <br /> CALL ENGINEERING DEPT. 259�8811 Telephone Number <br /> �. �, _ : -�._ <br /> 2A HOURS BEFORE CONSTRUCTION Date - � <br /> CHECK LIST Fee <br /> VJater Valve <br /> Drainage Dept. Approvals <br /> Curb&Gutte� � Engineers � - <br /> Sidewalk <br /> Water <br /> Street <br /> Inspec nature Communications <br /> Traffic <br /> ���R�� Planning <br /> ate <br /> Remarks 5-. . <br /> 11292 - <br /> APProved by .i' ,� I I._.-. <br /> ..i'..(.�.' � F,,',i. ,,-�i <br /> INSFECTOIi'ti COPI' Date Approved 4- ���� -�,�, � 0 <br /> ��/ � )�y <br />