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�,�i,«,i� APPLICAiION FOR RIGHT-OF-WAY USE PERMIT <br /> � <br /> CITY ENGINEERS <br /> EV[RETT, WASHINGTON <br /> PERMI i NU. <br /> T��e Undersigned ;�,� , . ------ <br /> H���I>Y applies for permission to_ ���I-, i ' !; ��.. - . . . i _ - _ <br /> ..-_ '. i�' .✓�� \,i ... .. - <br /> At the following location ,o � % '. _ �{ . ..� i�.,. _ _ ,'. _ <br /> • r <br /> SK[TCH <br /> _-- <br /> VJurk lo bc u'one� -��---- -- <br /> � <br /> DRIVEWAY SECTION <br /> NO SCALE T��� ����dersigned owner hereby agrees [o hold and <br /> �^ _- '�,`,' - ._. __� save harmless thc City of Everntt fwm any ;md oll <br /> --- claims for damages that may arise because of Installa- <br /> ��-� . _ ��- ��� - -� tion and mainrenance of the improvement hereto <br /> � -j��-- � �30'� ��PPlied for and (urther agrees to remove same upon <br /> notice (rom the City and to replace public propr.rty <br /> d;�ntaged thereby, <br /> Siqnature of Applicant --` ------- <br /> � '�� 01- THIS APPLICATION TO � � Address � '�""�� <br /> � ��.]STED ON JO�SITE. <br /> CALL ENGINEERING DEPi. 259�8811 Telephone Number � ���� � - - <br /> 2�1 HOURS BEFORE CONSTRUCTION Date �-- - - <br /> CHECK LIST _ <br /> � �Water Valve Fee .. ---- -�-�-�-------- _ . <br /> Drainage Uept. Approvals <br /> Curb&Gutter <br /> ISidewalk Engineers__,__ _ _ <br /> YJatcr <br /> _____�-------- <br /> , �`y��� '/f Sireet_ <br /> �� , ., -.. -- <br /> i'.��r���cmr'sSignature � I"�-�- "- - ,`• , � Communications <br /> ��� � ` �- Traffic ' <br /> Il ��,; S <br /> /' Planning <br /> /��J �cJ � - <br /> � ---- •,y --- <br /> ,:,� <br /> '�i�uroved by <br />