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eve�ett <br /> APPLICATION FOR RIGHT-OF-WAY USE FERMIT <br /> � ` � L � � <br /> \ <br /> CITY ENGINEERS I� n <br /> EVERETT, WASHINGTON PERMIT N0. �� � �� <br /> The Undersigned � <br /> Hereby applies for permission [o � - - <br /> At the following location � <br /> SKETCH <br /> (Work [o be done) <br /> � � ,�S'� � �-.- _. <br /> j_ �7rr . ��:w <br /> � _ '�. _ <br /> " ,�i �-f� . <br /> � , 3 <br /> �y�� <br /> . � � � <br /> ORIVEWAY SEC710N The undersigned ovmer hereby agrees to bold and <br /> rv0 SCALE save hnrmless the City of Everett irom any and all <br /> � - -- - -� claims for da.�nar,es that may arise because of installa� <br /> �+�'� LIP tion aod mai�t�_nance of the improvemm.�t herero <br /> L30" I gp I applie.l (or and further agrees to remove same upon <br /> I�� --�-----------�-- --�1'--���'1 noti:e from the City and to replace public properry <br /> damaged thereby. <br /> Signature of Applicant -- <br /> COPY OF THIS /iPPLICAT10N TO Address <br /> BE POSTED ON!G�SITE. : � / ,• �?_J:.-j�', " <br /> Telephone Number . <br /> CALL ENGINEERING DEPT. 259-8811 , � .��— � i ; r . _ <br /> �24 HOURS BEFORE CONSTRUCTION Date <br /> CHECK LIST Fee <br /> Water Valve � <br /> Drainage Dept. Approval5 � <br /> Curb&Gutter Engineers - <br /> Sidewalk <br /> Water <br /> � � � ��j � Street_ <br /> ��l Communications <br /> �Inspector'sSignature ' <br /> � Tra(fic <br /> � p , '� � Planning <br /> —�te� (� / <br /> � <br /> Remarks <br /> :1. 1205 - <br /> Apprwed by i � . <br /> . _ Date Approved 3 <br /> �� <br />