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everen <br /> APPLICATION FOR RIGHT-OF•WAY USE �ERMIT <br /> � <br /> CITY ENGINEERS <br /> EVERETT, WASHINGTON PERMIT N0. <br /> The Undersigned . <br /> Hereby applies tor permission to � � � <br /> . <br /> At the following location � � � — <br /> SKETCH <br /> (Work to be done) .. _ <br /> ,� i , <br /> � � <br /> �- -i <br /> � i <br /> Jl�� <br /> - ' � �;. . �C. � �V <br /> -- — r - � \ <br /> �:,ri�� �lv�. . ��� t '1�\ � � <br /> ls -� l �l �, <br /> ��ll('�Ci' C�1cr�e nF Fc <br /> DRiVEWAY SECTION The undersigned owner hereby agrees ro hold and <br /> {,, NO SCALE save harmless the City of Everett irom any and all <br /> I - � claims (or damages that may arise because of installa� <br /> I" LIP tion and maintenance of the improvement hereto <br /> L30' I 4 I gp I applied for and further agrees ro remove same upon <br /> I —� -----�--- -------'1'--,'1 notice irom the Ciry and to replace pu6lic property <br /> damaged thereby. <br /> Signature ot Applicant - <br /> ..--- - . . . _ � � . , .. <br /> COPY OF THIS APPLICATIOi�' TO Hddress . <br /> BE POSTED ON JOBSITE. � � <br /> CALL ENGIN[ERING DEPT. 259�8811 Telephone Number <br /> 24 HOURS BEFORE CONSTRUCTION Date � <br /> CHECK LIST Fec <br /> Water Valve <br /> Drainage Dept. Approval5 <br /> Curb&Gutter Engineers � <br /> Sidewalk <br /> Water <br /> Street <br /> — Communications `� <br /> Inspector's Signature <br /> Traftic <br /> Planning <br /> a[e <br /> Remarks <br /> � �� �; :-, f 1 <br /> Approved by <br /> . �. Date Approved 0 <br />