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everclt <br />� <br />CITY ENGINEERS <br />EVERETT, WASHINGTON <br />The Undersigned i7i� v i n <br />Hereby applies for permission to <br />APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />At the following location �. y .3 )- � •j �/ / � �- �"> > � � �i='•'y <br />(Work !� be dane) <br />' DRIVEWAY SECTION <br />NO SCALE <br />� � <br />II" LIP I <br />� I 3-0�I--- ----4-30" �I <br />COPY OF THIS APPLICATION TO � � <br />BE�POSTED ON JOBSITE. <br />CALI. GNGINEERING DEPT. 259�8511 � <br />I <br />24 FIOURS BEFORE CONSTRUCTIOfV, <br />CHECK LIST <br />Water Valve <br />Drainage <br />Curb & Gutter <br />Sidewalk ��D%%�j�f:� "��-f-.' <br />/ � <br />Inspector's Signature <br />Remarks <br />Note: Original to Customer <br />1 Copy to File 10857 <br />1 Copy to Inspector <br />� , �' i� �'.. � �-.;,..:�f> ^�r;: <br />�/-' °` % �ij <br />10857 <br />PERMITNO, i%-/�Y <br />The undersigned ownr.r hereby agrees to hold and <br />save harm�ess the City of Everet[ .`rom any and all <br />claims for damages that may arise because of installa- <br />tion and maintenance of the improvement here[o <br />applied for and further a9rees to remove same upon <br />notice from the City and to replace public property <br />-dara ed thereby. (� � <br />� 1 l�— I�..� !L�-,l� _ <br />PP <br />�i� ur f A lican�'�hA` /� _ ^ /, <br />// �L <br />A dress �r T <br />`iSs--J I�S <br />Telephone Number ^ <br />� —%�%�� f <br />Da[e � ., <br />/;� - .n "� <br />Fee <br />Dept. ppr als <br />Engineers_L ����f'� <br />Communications <br />Approved by <br />Date Approved <br />