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APPLICATION FOR RIGFiT-OF-WAY USE PERMIT <br />�ver^tt � <br />� <br />CITY ENGINEERS <br />EVERETT.WASHINGTON <br />The Undersigned 1— K �\ <br />Here6•; applies for pertnission to <br />At thc following location r0 � ! �- E C� 1 O!� ��'C. <br />jWorlc tn be dc <br />10036 <br />PERMIT NO. '7 � ��'' <br />DRIVEWAY SECTION <br />NO SCALE <br />r - ZC�' -~{ <br />I" LIP <br />30'� _ I 30,� <br />-��. <br />�COPY OF THIS APPLICATION TU �', <br />I BE POSTED ON JOOSITE. <br />i CE11.L [DIGIt�!fFRING DEPT.259�881 t <br />I24 HOUR ; R[f-iiR[ CONSTRUCTION <br />�HECK LIST <br />Water Valve <br />Drainage <br />Curb & Gutter <br />Sidewalk <br />�r�:� �i/� -- <br />Inspector's Signawre <br />4�-1 l� - —)y <br />-iSate <br />Notc: Original to Customer <br />, �oPY �o F��� 10 Q 3 6 <br />1 Copy to Inspec[or <br />�'�2`� . <br />� a. . � � <br />�FL11J 6-`� � <br />� <br />The undersigned owner hereby agrees to hold and <br />save harmless the City ot Everett fro�n any and all <br />claims for damagas that may arise because of installa- <br />tion and maintenance of the improvement heret:o <br />applied for and further agrees to remove same upon <br />noticc .`romf� e yty and to repla c publi property <br />dar�eced thffe 1 � n� <br />� <br />� r ui � <br />Telephone Number /� � ^ U l/ � / <br />l� <br />Date T,-� <br />_" ��'�_� i� 8/�i7� <br />Fee <br />� -..J - i ;�n < <br />Ap�roved b� 2H���"'`°� � � <br />� � � .-' <br />_� <br />Date APProved <br />