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everen <br />� <br />CITY ENGI�dEERS <br />EVERETT. WASliINGTON <br />The Und2rsigned <br />Hereby applies fo <br />APPLiCATION FOR RIGHT-OF-WAY USE PERMIT <br />1�sas <br />PERMITNO. 7 �/�? 7 <br />At the following locaticn ,5 � /'v1 r=i'�'� /::� i�/ <br />SKETCH <br />(Work to be done) <br />DRIVEWAY SECTION <br />NO SL'ALE <br />��—, — � <br />� � �i LIP <br />�30'�_ �I <br />�COPY�OF THIS APPLICATION TG �I <br />BE POST[D ON JOBSITE. i <br />iCALL ENGIN6ERIN3 DEPT. 2.'i&E81 7 i <br />24 f-IOURS 6EfORE CON,TRUC�IO;J� <br />CHECK LIST <br />� Water Valve <br />Drainage <br />Curb & Gut[er <br />�� Sidewalk <br />In<pector's Signature <br />a[e <br />Remarks <br />Note: Original to Customer <br />1 Copy to File ��! � 0�'. � <br />7 Copy ?o Insoer.t�r <br />� p �= l'T77'�iG /4 � r'i <br />The undersigned owner hereby agrees to hold and <br />save harmless the City of Everett from any and ail <br />claims for damages tha[ may arise because of installa� <br />tion and maintenance of the improvement hereto <br />applied for and further agrees to remove same upon <br />n�iSB�-from the City and to replace ublic property <br />daqiag, thereby. <br />1 �. <br />Sigm ire of Applicant' <br />c,'�2 /D /–'iiiF.,, � , � ,p mr� ,LK�-y <br />�ress / <br />3�r�• 7700 <br />Telepl;one Number <br />�*�` '7�/S/77 <br />Date a <br />�� f %�r�7> : + <br />Fee — <br />Dept. A provals <br />Engi�eers ._.i ��� �i.�N. . <br />Communications <br />Aoproved by <br />Date Approved <br />