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everetl <br />� <br />CITY ENGINEERS <br />EVERETT.WASHINGTON <br />The Undersigned <br />Hereby applies for permission to <br />At the following <br />APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />PERMIT NO. <br />SKticn _ � . „ � _ - <br />(Work to be done) . . � . .. �. . � , .. . . .. ���'���. � . . . . <br />� . . . � . �i.-i ,-�/„%%//r�� /� <br />/P,F!_�,, �A ,T�l� ,l>''l C'_ l �,,�r <br />ORIVEWAY SECTION <br />NO SCALE <br />� —1 <br />+I" LIP � <br />�30�— �_—�3��� <br />COPY OF THIS APPLICAT!ON 1"0 <br />BE POSTED ON JOBSITE. <br />CALL [NGINEERING DEPT.259�8617 <br />24 HOURS BEFORE CONSTRUCTION <br />CHECK LIST <br />Water Valve <br />Drainage <br />Curb & Guttrr <br />Sidewalk <br />Inspector's Signature <br />,/, <br />`k� r,.�.. c/ , , <br />/ ��'y� / � <br />C�%..�'/..;i r'/il,�i7:^�i2 (�.�..V; <br />� <br />The undersigned owner hereby agrees to hold and <br />save harmless the City of Everett from any and all <br />claims for dama9es that may arise because of installa• <br />tion�and maintenance of the improvement hemro <br />applied for and further agrees to remove same upon <br />no[ice from the Ciry and ro replace public property <br />dama5ed thereby. <br />Signature of Applicant <br />Address <br />Telephone Num6er <br />Date <br />Dept. Approvals <br />Engineers <br />Commun <br />Plan <br />Approved by <br />Datc Approved 0 <br />