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everett <br />' � <br />CITY ENGINEERS <br />EVERETT, WASHINGTON <br />The Undersi�ned � � <br />Hereby applies for permission to <br />At the following location_ <br />(Work to be done) <br />APPLICATION FOR RIGHT•OF-WAY USE PERMIT <br />� il <br />� �',i� .� ��� <br />1i25� �;)¢ <br />� <br />PERMIT N0. <br />I <br />� ���� v �� <br />' ?a�z <br />„o�`, t,� ,N� <br />�;� a���� � �� , <br />vc�' �..°' ';Y <br />aJ'� ? 1-3� <br />�e �R ia: ��..�.:' �� <br />.\p���;�`' f���'� . �� , f*"' <br />p r i. <br />i'. . �.� <br />� � c-, ! _ <br />ORIVEWAY SECTION <br />NO SCALE � <br />I <br />+I" LIP � <br />4 30"f _ 30" <br />i <br />COPY OF THIS APPLICATION TO <br />BE POSTED ON JOBSITE. <br />CALL ENGINEER�NG DEPT. 259�8811 <br />24 HOURS BEFORE CONSTRUCTION <br />CHECK UST <br />Water Valve <br />Drainage <br />Curb & Gutter <br />Sidewalk <br />Inspector's Signature <br />Remarks <br />��1 <br />�� /-.�.:�� \ J <br />� � ����-�" <br />� �J-' <br />,%/., .. <br />./ � -:��:�.1�i�E�c�+e /�c.ic�,v�,-c— <br />=(. n — n <br />.1�.��� <br />FILE COPY <br />The undersigned owner hereby agrees to hold and <br />save harmless the Ci[y of Everett from any and all <br />ciaims for damages that may arise because of installa� <br />tion and maintenance of the improvemen[ hereto <br />applied for and further agrees to remove same upon <br />notice from the City and to replace public property <br />damaged thereby. <br />Signature of Applicant <br />, <br />Address " <br />� <br />� _; ��( � j <br />Telephone Number �_ � <br />i. . " '-" <br />Date <br />Dept. Approvals <br />Communications <br />Approved by <br />Date Approved Q <br />