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everett <br />� <br />CITY ENGINEERS <br />EVEREiT, WqSHINGTON <br />The Undersigned . !�� : � <br />Hereby applies for permission to <br />At the following <br />(Work to 6e done) <br />APPLICATION FOR RIGHT-OF•Wqy USE PERMIT � <br />�� ... ._ W. ;;, ��i <br />Q9 <br />DRIVEWAY SECTION <br />� IVO SCALE <br />II \ � I�� LIP—��� <br />1 30�f•_— ._ 30,� <br />I �OPY OF THIS APPLICATION TO <br />; i:[ POSTED ON JOBSITE. <br />; CALL EN ,INEERING DEPT.25&8g71 <br />'�:HOURS�EFORECONSTRUCTION <br />CHECK LIST <br />Wd[�f Vd�JB <br />Drainage <br />Curb & Gutter <br />Sidewalk <br />Inspector's Signature <br />Remarks <br />11 � C; � <br />7Q � <br />PERMIT NO.�a <br />r �, <br />� <br />� <br />� �y <br />�: :;, <br />. <br />� ����� � �. � . <br />�a. � �-.. <br />The undersigned owner hereby agrees to hold and <br />save harmless tbe City of Everet[ from any and all <br />clafms for damages that may arise because of installa� <br />tiori and maintenance of the improvement hereto <br />eP?�ied for and further agrees to remove same upon <br />notir.e. from the Ciry and to replace public property <br />���igetl thereb <br />� /' % <br />� !�' � Y/( �/ �� <br />y ail]fe pf / `�" <br />Appncant <br />—1���1'vit.zr r� <br />Addre,s <br />"s3_� _ >7ca <br />Telephone Number <br />� ` — 7� <br />Dare /7 /J / <br />h2--�=l�J / C�( — �� / // �J <br />r-�,••;_ a =.,,-� _,, <br />