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� <br />• everett <br />e <br />CITY ENGINEERS <br />EVERETT,WASHINGTON <br />The lfndersign.:tl i f � <br />Hereby applies for permission to <br />APPLICATION FOR RIGHT•OF-WAY USE PERMIT <br />At [he following location -��-_ -� - <br />. � �= __. <br />SKETCH <br />(Work to be done) <br />�, DRIVEWAY SECTION <br />NO SCALE <br />� � <br />i � I" LIP � <br />'�' I 30'��. .�3� <br />�F -t <br />COPY OF THIS APPLICATION TO <br />B[ POSTED ON J06SITE. <br />CALL ENGINEERING DEPT. 259�881 I I <br />24 HOURS BEFORE CCNSTRUCTION� <br />CHECK LIST <br />Water Valve <br />Drainage <br />Curb & Gu[ter <br />Sidewalk <br />Inspector's Signature <br />uace -� <br />Remarks <br />Note: Original to Customer <br />1 Copy to File ��� 3 Q <br />1 Copy to Inspector <br />� �°, .-'= �..i�- <br />.i. .- . , , � . -� . .. � <br />10930 <br />PERMIT N0. �'� ��'� -' �i �' <br />a <br />The undersigned owner hereby agrees to hold and <br />save harm�ess the City of Everett from any and �II <br />claims for damages that may arise because of installa- <br />tion and maintenance of the improvement hereto <br />appiied for and further agrees to remove same upon <br />notice from the City and to replace public property <br />dam g�d thereby. ,��. <br />-,.�i �� .4, '7 ��i : .(-�i� `(J <br />i .�V"+'�r. <br />Signature of Applicant � /_� � ! .� <br />f% � i!�. o. . ii !-"/� f�.\- , <br />nda��- ^`—? <br />• — r ; . ._ %:.� .. :�,F �� <br />l�elephone Number <br />�� �S—_. �f�-/�/ )-- <br />Date /� /, <br />;� } <br />Fee � <br />Dept. Approvals <br />Communications <br />Approved by <br />Date Appioved <br />