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APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />10898 <br />CITY ENGINEERS <br />EVERETT, WASHINGTON <br />The Undersigned <br />Hereby applies for permission to <br />At the following <br />(Work to be done) <br />DRIVEWAY SECTION <br />NO SCALE <br />I" LIP <br />30' <br />COPY OF THIS APPLICATION TO <br />BE POSTED P" IOBSITE. <br />CALL ENGINLERING DEPT.259.8811 <br />24 HOURS BEFORE CONSTRUCTION <br />Inspector's Signature <br />Note: Original to Customer <br />1 Copy to File 10898 <br />1 Copy to Inspector <br />PERMITNb.-1 /- <br />4. if,: ' <br />6 <br />The undersigned owner hereby agrees to hold and <br />save harmless the City 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 agrees to remove same upon <br />notice from the City and to replace public property <br />dam bd thereby. -� <br />Signature of Applicant <br />/2 2- <br />Address <br />Telephone Number <br />Date <br />F;f^ <br />Dept. Approvals <br />Engineers <br />Water_ <br />Communications <br />Approved by <br />Date Approved <br />