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everen <br />APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />Type or print clearly with Ink <br />PRESS HARD - YOU ARE MAKING COPIES <br />PUBLIC WORKS <br />EVERETT, WASHINGTON PERMIT NO._ <br />APPL'CANT (UNDERSIGNED) AND FIRM REPPESENTED, IF ANY <br />HEREBY APPLIES FOR PERMISSION <br />AT THE FOLLOWING LOCATION <br />i <br />DRAWING (WORK TO BE DONE) OR THRFE PLANS ATTACHED: �%Ly <br />CONDITIONS <br />1. Existing sidewalks, curbs and gutters are undamaged - any damage done <br />to same during construction will be repaired or, removed and replaced to <br />the P.W. Inspectors satisfaction. <br />2. Existing driveways, should be utilized for new homes, if new driveways have <br />to be installed - the existing curbs and gutters must be totally removed <br />and replaced at new driveway location - KNOCKING OFF OF CURB IS NOT <br />ALLOWED. <br />3. All concrete remr.,vals must be saw -cut or taken out to nearest expansion <br />joint. <br />N - r <br />ol� V-)/ <br />�E4 <br />PERMIT IS VALID FOR 60 DAYS <br />COPY OF THIS APPLICATION TO BE POSTED <br />ON JOBSITE. <br />CALL FOR INSPECTION 259-881 1 <br />24 HOURS BEFORE CONSTRUCTION <br />SEWER <br />DRAINAGE <br />DEPARTMtI:T APPROVALS <br />COMMUNICATIONS <br />WATER � � - PLANNING <br />.— <br />STREET <br />7— � //Qv <br />APPROVE.. ONSTRUCTICN -�� -��� � ATE <br />.igcU e;foW �.i �;5 <br />APPROVED AS CONSTRUCTED DATE <br />DRIVEWAY SECTION <br />The undersigned owner hereby agrees to hold and save harmless <br />the City of Everett from any and all claims for damages. costs. <br />expenses. or causes of action that may arise because of installation <br />and maintenance of the improvement or other right-of-way use <br />hereto applied for and further agrees to remove same upon relics <br />from the City and to replace public property damaged thereby. <br />SIGNATURE OF APPLICANT <br />-e// 57 <br />ADDRESS <br />CITY ZIP <br />4412 / — <br />TELEPHONE NUMUER ALTERNATE <br />7- /- rn - <br />DATE <br />