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c-vcrett <br />� <br />CITY ENGINEERS <br />EVERETT, WASHINGTON <br />AF'PLICATIQN FOR RIGHT-OF-WAY USE PEHMIT <br />PERMIT <br />L052`� <br />,i - <br />The Undersigned i - , �� a <br />Hereby appiies for pertninion to _ I �� 1- l) �+ �j � �c� r � !c i i f r � r � f � r-p n � <br />� } , I - ln <br />At the follcwing locatiun_ _ � � q�- /� f � � P <br />(Work [o be done) <br />DRIVEWAY SECTION <br />NO SCALE <br />F _ _--_ \/ — - � <br />� �\ <br />I�-_ �1„ LIP <br />`30� �__-- �30"�; <br />� -''�"� �:�F THIS APPLICATIGfV TO <br />�-: F'i�;TED ON JOBSITE. <br />�:%..;.L FPdGINfERiNG DEPT.259�8871 �. <br />7�1 HqUi�; [3�FORE: cONSTRUCTIGN� <br />CHECK LIST <br />Wator Valvc <br />Drainaoe <br />Curb & Gutter <br />Sidewalk <br />— _ L_ <br />Inzper.mr's Signamre <br />Hcmarks <br />fvote: Origi�al m Customer <br />1 Copy to Filc � �' <br />�'�.`:',� ?1 <br />1 CoPV to Insp��ctoi � � <br />.. -1 :.. ._.,, . ,_; r.i ,i <br />N� Scolr- <br />� � ...., ., �,, <br />' I� / . /i <br />I <br />The undersigned owner hereby agrees to hold and <br />save harmless the City ot Everett from any and all <br />claims for damages that may arire because of installa� <br />iion and maintenance ot the improvement hereto <br />applied for and further ayrees to remove same upon <br />notice from U:e City and to replace public property <br />damaged then;by.. <br />�i�- _ <br />Signa W re ut qpphcant <br />� � ( <br />Address � <br />, �. . �-; � %� <br />Telephone Number <br />^-' , / �/-- - <br />Fec - ---- -"- <br />Dept. Approvals <br />En�ineers�_�' �'�`��a'� <br />Water fi���c ��PPf�C�.'�� — _— . �. <br />I•-; <br />Ccmmunicatio <br />Traffic - ^ �� - _ �./_, <br />` <br />Plannin <br />Sewer, Nc; 7'�,.� nc�y. I��--�. <br />� � - <br />APPrOved bY;� i � � i . �' i <br />- ---L'------ - ..-- <br />Dntc Appioved � <br />