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APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br /> everetl <br /> � 11�60 <br /> CITYENGWEERS � ), <br /> EVERETT,W,15HINGTON PERMI'f N0. �/.� \C <br /> i <br /> The Undersigned__ I� ,-1 � � , �- , <br /> Hereby applies for permission to � ,v �- ' T� - i " '/., . � <br /> At the following location__ � __` _ __ ___ <br /> SKETCH <br /> IWork to be done) � <br /> , . - � <br /> 'i <br /> i <br /> I <br /> I <br /> II <br /> � <br /> I i <br /> I <br /> i <br /> I <br /> i <br /> I � <br /> , DRIVEWAY SflCTION The undersi,ned owner hereby agrees to hold and ' <br /> � NO SCALE save hannless the Ciry ot Eveiett from any and all . <br /> '"---" ---" --- --"'I claims for damages that may a�ise because of installa� <br /> ��� ��P � tion and maintenance of the improvement heieto <br /> applied for and further agrees to remove same upon <br /> 30' I 30" m�tice from the City and to replace public property <br /> --�------�}�-� . <br /> damaged thereby� , �� � <br /> ,�:�r �l. ;,� :, � �� _ <br /> Signature f ApPlicant <br /> ->=-=%�'=; <br /> �� � ' /=c✓ ,'(/�J '='T <br /> �COPY OF THIS APPLICP.TIOP� TU� � I, Address � <br /> BE POSTED O;J JOBSITE. - S_� G '7 , <br /> i CnL'._ [f�!GI.I[ERING DEPT. 259�&tii 1 i Telephone Numbe� r_ � <br /> i �/ <br /> j ?4 HOUI;S f3Ei_OR[ C,OPiSTRUC�i IC;N Date � <br /> CHECK LIST Fee . <br /> Wator Valve Dept. Approvals <br /> Drainage � r <br /> Curb&Gutter Engineers ��� ' <br /> i.; <br /> --t"------ <br /> Sidewalk _ Water_ <br /> Street <br /> Ccmmunications <br /> Inspecmr's Signature <br /> Tratfic <br /> Planning <br /> � <br /> Remarl:s . — <br /> Notc:: Oriqinal to Customer <br /> 1 Copy to File " `� n� �' <br /> 1 Copy to InsPector I. ..' �. '. � Approved by <br /> Date Apprwed <br />