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APPLICATION FOR RIGHT-OF-WAY USE PERM�'T <br />ev�;ren <br />.� <br />10990 <br />CITY ENGiNEEP.S '% � <br />F.VERETT, WASHINGTON PERfvlff N0. - � <br />TheUndersigned_�/'J�` r�L'=Ji/ <br />Hereby applies for permission to ��f,r:�l �i ' i r•� ? �� �/� `;��� 1�.'� — <br />At the following lucation 7�57� � T( j��1Z— �.�� �� ��� � y� �' <br />(Work to be done) <br />DRIVEWAY SECTION <br />NO SCALE <br />�— —� <br />� +I�� LIP � <br />�0+__.— _—�f•3� <br />COPY OF THIS APPLICATIOfJ TG � <br />BE POSTED ON JOBSITE. � <br />CALL FNGINEERING DEPT. 25&f1Ff11 �'i <br />-24 HOURS ��CFORE Cn���1�;THU_r,ilON� <br />CHECK LIST <br />Water Valve <br />Drairage <br />Curb ik Gutter <br />Sidewalk <br />Inspector's Signature <br />Remarks <br />� Note: Original ro Customer <br />, �o��Y to F��e 1(t 9 9 0 <br />' 1 Copy to Inspector <br />s C.� r� r�/tc. it` �� <br />Tha undersignad owner hereby agrees to hold and <br />save harmless [he Ciry of Everett from any and all <br />claims for damages that may arise because of installa- <br />tion and maintenance of the improvement hereto <br />applied for and further agrees to remove same upon <br />netice fro�i(y and to replace pub� properry <br />�2 .Q = C'd,/r dri�.v Gl�� Y <br />, <br />r� � C— 3— 5�_i 3� <br />� .............. .. _....._. <br />-Lz-7� <br />Date ,� � <br />i i = �%�� <br />Fee <br />Dept. ,�provals <br />, � <br />Engineers.��� ��.�-���--+`� <br />Communications <br />Planning_ <br />Approved by <br />Dace Approved <br />0 <br />