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161 <br />CITY ENGINEERS <br />EVERETT, WASHINGTON <br />The Undersigned <br />Hereby applies for permission <br />At the following <br />(Work to be done) <br />APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />DRIVEWAY SECTION %ter-' / <br />NO SCALE / <br />�-17 <br />I" LIP <br />COPY OF THIS APPLICATION TO <br />BE POSTED ON JOBSITE. <br />CALL ENGINEERING DEPT. 259-B811 <br />24 HOURS BEFORE CONSTRUCTION <br />j <br />ECK LISTer Valveinagab 8, <br />Gutter <br />Sidewalk <br />r _ %NOC RuN '.}�wY, WAt'ER ou ru SrKECT <br />Inspector's Signature <br />ate <br />Remarks <br />Note: Original to Customer <br />1 Copy to File 1055.6 <br />1 Copy to Inspector <br />�. 10556 <br />PERMIT NO. <br />The undersigned owner hereby agrees to hold and <br />save harmless the City of Everett from any gnd all <br />claims for damages that may arise because of inta'la- <br />tion and maintenance of the improvement 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 />Address <br />Telephone Number <br />- i/--7L <br />Data / s <br />Fee �124.4 F — �G��re -- <br />Dept. Approve s <br />Engineers _z� <br />Water l?.1", e- /i.E�i-crrl. <br />Street �)j <br />Communications <br />Traffic ;A h <br />Planning--, rr;�Yn <br />Approved by <br />Date Approved <br />