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� <br />- .�, eceretl <br />� � � � <br />CITY ENGINEERS <br />EVERETT, WASHINGT(JN <br />The Undersigned � <br />Here�y applies for permission to <br />At the following lo�ation_ <br />(Nbrk m be donel <br />--r:. <br />A��'PUCATION FOR RIGHT-OF-WAY USE PERMIT I� 2 O G <br />PERMITNO. �� - � <br />-- � <br />i <br />. _ . . ._._. .l <br />i�!ri�L� ri <br />DRIVEWAY SECTIGN � <br />NO SCALE <br />� i ---- – --� <br />+�,� LIP ' : 'I____. .. _. _ <br />30 I ___ _ __ I 30,� <br />—�j• <br />COP��' OF THIS nPPLICATION TO <br />BE POSTED ON JOBSITE. <br />� CALL ENGINEERING DEPT. 259�887 7 <br />24 HOURS BEFORE CONSTRUCTION <br />CHECK LIST � <br />Water Valve � <br />Drzinage - - -- � - <br />Curb & Gu[ter <br />Sidewalk <br />Insp^ctor's Signaturc <br />Remarks <br />... �! . . ' � � �1 <br />I <br />The undersigned owner hereby agrees to hold and <br />save harmless the 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 agrnes [o remove same upon <br />notice from the City and to replace public properry <br />damaged thereby. <br />Siqnature of Applicant . <br />Address . _ � . <br />Telephone Number � <br />Date <br />Fee <br />Dept. Approvals <br />Communications <br />7I/ � <br />/` r .,, -/ <br />•.. . . ��/'� ��flL <br />�I'� /:I_.y <br />� .� . i ' n <br />i � <br />