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% APPLICATION FOR RIGHT-OF-WAl' USE PERh11T <br />. ,.,.��� , � 10907 _ .. <br />� . <br />� <br />CITY ENGINEERS � � ,.,c, <br />EVERETT, WASHiflGTON � PERMIT N0. � �__ <br />The Undcrsi9ned _��Tf'� G,Z� S7 ('.nrv cTR�!'r� �� Co � <br />Hereby appfics for permission to Go,�.' SYX�a T%.'f�L;= << 3� %;ty'y`�� ������ �S —�' � 7�� <br />=—i <br />i ��� <br />At [hc following <br />(Work to be done) <br />� <br />ORIVEWAY SECTION <br />NO SCAIE� <br />� ll �' / I <br />30'� _ �_ 30" <br />COPY OF THIS APPLICATION TO <br />BE POSTED ON J06SITE. <br />CALL [NGIhFERING DEPT. 259�5811 <br />24 HOURS OEFORE CONSTRUCTION <br />CHECK LIST <br />Wator Valve <br />Draina9r. <br />Curb & Gunr.r <br />Sidewalk <br />Inspec[or's Siqnawre <br />i3ato <br />Remnrks <br />Note: Oripin�l to Customcr <br />t Cnpy tn Fi�c 1��� 7 <br />1 Cupy lu �m��n'.lor <br />SEE �FYTAtHcO <br />�' •j�'�, �?���%� <br />i <br />� � <br />.��'` <br />The undersigned owner hereby agrees to hwld and <br />save harmless the Ciry of Everett from any and ali <br />clairtis for damages that may ari:e because ef installa� <br />tion and mafitenanct of the improvement hereto <br />applied for and further a9rees to remove same upon <br />rotice trom thc City and to rep ce publiG property . J <br />darr�aged thereby. �jy%�. �,Lt.-YKrI� <br />Telephone Number <br />Date ` <br />z <br />�!3°� ��F _ l;So: <br />Fee g ' <br />Dept. Appr vals " o 0 <br />Yl. <br />Engincers 1� <br />Strect _ <br />Communicationt <br />Planning_ <br />APprnvrd by <br />D.�1^ !�{�In nvud <br />%� <br />