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• � e;erett <br />. e� <br />CITY ENGINEERS <br />EVERETT,WASHINGTON <br />The Undersigned _ <br />Hereby applies fur permission to <br />At [he following <br />(Work to be done) <br />__1Z <br />APPUCATION FOR RIGHT•OF-WAY USE PERMIT '� j 2 O 3 <br />PERMIT N0. <br />. - , . . . , . . �. � � �- ' <br />DRIVEWAY SECTION � <br />NO SCALE <br />� — __� <br />� \ +I•� LIP i � <br />I 3p� I."___ ___—�•30�� <br />� — i <br />COPY OF THIS l�PPI_ICATION TO <br />3E POSTED ON JOBS17P. <br />GALL ENGINEERING DEPT. 259�8817 <br />24 HOURS BEFORE CONSTRUCTION <br />- -- ---- i ---- <br />CHECK LIST �� <br />N�ater Valve <br />Drainage <br />Curb & Gutter <br />Sidewalk <br />Inspector's Signature <br />/ Z. <br />i <br />The undersigned owner herel�y agrees to hold and <br />save harmless thc City of Everett from any and all <br />claims for damages that may arise because of installa� <br />... tion and maintenance of�. the improvement herero <br />applied for and further agrees to reinovc sxme upon <br />notice from the Ciry and to replzce public property <br />damayed thereby. . � <br />Signature of Applicant � <br />, <br />Telephone Number <br />Date <br />Dept. Approvals <br />Engineers <br />Communications <br />Plann <br />—��`7 <br />� � � �'�i������/��i1 <br />, <br />�. , . . <br />. <br />