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APPLICATION FOR RIGHT-OF-WAY USE PERMIT 116 3 8 ; <br />everex <br />CITY ENGINEERS PERMIT NO. A367 4 <br />EVERETT, WASHINGTON <br />The Undersigned ' <br />Hereby applies for permission to <br />6 9 2 D q %' i o rw ; <br />location <br />At the following r`.a <br />SKETCH <br />(Work to be done) <br />Sorry, eAU <br />1N T 1 NSP rrc c, <br />� ��,z� R�qu�AP-AP=Aj� r � <br />nRIVEWnY SECTION The undersigned owner hereby agrees to hold and <br />save harmless the City of Everett from any and all <br />No 3"LE claims for damages that may arise bKOU90 of instalid- <br />tion and maintenance of the improvement hereto <br />I' LIP applied for and further agrees to remove wne upon <br />notice from the City and to replace public property <br />4agnaged th4'fW�-,y _ j _ _ . M <br />COPY OF THIS APPLICATION TO <br />BE POSTED ON JOBSITE. Teelleph^ pne Number <br />CALL ENGINEERING DEPT. 259-8811 Dan "t it <br />24 HOURS BEFORE CONSTRUCTION %GGi:VO e-31:41 "?�9 <br />Fee <br />CHECK LIST Dept. Approvals <br />Water Valve <br />Drainage Engineers <br />Curb &Gutter Water <br />Sidewalk <br />Street <br />Comm jnications <br />Inspector's Signature Traffic <br />Planning <br />ata <br />Remarks 11638 <br />Approved by .:, r�,t:}�.,•'rpij'.. <br />Date Approver <br />