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et�erctl <br />� <br />CITY ENGINEERS <br />EVERETT,WqSHINGTON <br />The Undersigned i' /-/, � r�.' <br />Hereby applies for permission to <br />At the following <br />SKETC�" <br />(Work to be done) <br />DRIVEWAY SEC710N <br />, NO SCALE— <br />f� -'i <br />\ i �.• LIP —� <br />�34y— ___.—.___._.�30 I <br />' --•1 <br />APPLICATION FOR RiGHT-OI�-WAY US� PERMI'i <br />COPY OF THIS APPLICqTION TO <br />� GE POSTED ON JOBSITE. � <br />C�1LL EdVGIN[[RING DEPT. 259-88I1 I <br />:'�i I IOUfi:i GEFORE CONSTRUCT�pNJ <br />CHECK L IST �� <br />Water Valve .� ,, •. t �� <br />Drainage � (�,t � <br />Curb & Gutter d <br />i <br />Sidewalk <br />Inspector's Signature <br />�Remarks <br />Notc: Original to Customer <br />1 CopY to Filc •j f1 O� O <br />1 Copy �o Inspecior .L IJ'7 J <br />108G� <br />PERMIT N0. � 7 (;! � __ <br />i <br />�_%1 / 1 i� PN - 7 �^�f, , <br />—��`_ <br />- /, _ _ , <br />, �! � i�.,.� � . � �l <br />The undersigned owner hereby agrees to hold and <br />save harmless ,he Ciry of Everett from any and all <br />claims for damages that may arisa because o( installa� <br />tion and maintenance of the improvement hereto <br />applied for and further agrees to remove same upon <br />notice from the Ciry and to replace public properry <br />da/ms(gr� �ereby. <br />/ ���/,1,� ii. � ; , <br />Si n ture of A � ���'--- <br />�� pp,icent <br />Addre sJ/ // C�� ----� <br />� �fr`/- OYL-t�5 <br />Te ephone um er <br />�.� ,* . <br />Fee ��/ � �.�—�--_: '-- G _�i: �% <br />/�yDept. Approyals <br />,�Z / . <br />Engin ers �.�,'?t , � /;;� /.���r.. .-� <br />Com <br />Flpproved by <br />Datc Flpproved �--- — <br />