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everen APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br /> � � <br /> CITY ENGINEEHS �� �� <br /> EVERETT, WASHIVGTON PERMIT N0. <br /> The Undersigned�i n,' r'., : � ,� � ^ � - _ ,, r ��,,��_�..�� <br /> Hereby applies for permission to /���:S7i-��:— P � C' c:n,v• ''T TJ/w l� ""�i+C' �' Ty-,E S1w <br /> _ �.� . � I`r-i'� ?�'� !�.?a TEr ' t r^ -J . <br /> At the following location ��.�o�� E?=^ i� � � <br /> c -ri•,: <br /> SKETCH <br /> (Work to be done� <br /> � <br /> I <br /> DRIVEWAY SECTION The undersigned owner hereby agrees to hold and <br /> nlo sca�E save harmless the City of Evcrett from any and all <br /> � � claims for damages that may arise because of installa� <br /> +f� LIP lion and maintenance of the improvement hereto <br /> �30" i —�— I 30" I applied for and further a�rees to remove same upon <br /> -'�'- � � �r -� notice (rom the City and to replace public property - <br /> damaged)tv reby. ` <br /> Sig�at e of Applicant — <br /> ( <br /> �,::ii'Y OF THIS APPLICATION !0 � Addre;s <br /> ' i;C FOSTED ON JOBSITE. II �- <br /> c:;-�,;.L GNGINEERING DEPT. 259�8811 i Telephone Number <br /> � '%41fOURS [3GFORE CONSTRUCTIONI Date <br /> . CHECK LIST Fee N� f(.�:.�' ' -- - � <br /> Wacer vaive Dept. Approvals � <br /> Drainage / <br /> Curb&Gutter —L S�� �/` � / - � � <br /> Sidewalk Engineers '!� _tK . <br /> T � <br /> Water <br /> Street <br /> Communications ' - <br /> Inspector's Signature. Traffic �'����' � <br /> Planning � . � <br /> a[c <br /> Remarks <br /> Note: Origina� to Customer � � <br /> 1 Copy to File . � <br /> 1 Copy to Inspector - � � -� Approved by <br /> Datc Approved <br />