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everen <br />� <br />CITY ENGINEERS <br />ENEPETT.WASHINGTON <br />APPLICATION FOR RIGHT•OF-WAY USE PERMIT <br />� , ..-= -' � � ������ Q�, <br />PERMIT NO. /'''" '- ! �S <br />The Undersi9ned �. ,; i V i,� �� ���- r i r,-' :, <br />Hereby applies for permission to F � �- r�i� ,i q 7_ " c l� !, ,,. .(- �� , /�.' {� �;'! �� J <br />` i <br />At the following loctticu,—_.� �. ', �'�. ' - - - ! �� .- . . � <br />(Work to be done) <br />,_� <'r,.,, :1 _ � <br />. ._��Y��J'�-<-Y-�fC K�Y� <br />� �� i . . . . �! `� � � ,. <br />��' <br />I •I <br />A � <br />�� � � <br />I <br />,. <br />s�� .i <br />i <br />� <br />-,; <br />ORIVEWAY SEC?ION <br />NO SCALE <br />r--- ---�— �--�� <br />I" LIP <br />L30'�__._ r_- _ _ __ _ I 30"� <br />i— Y <br />COPY Of- THIS APPLICATION TO <br />3E- POSTEJ ON JOBSITE. <br />CALL ENGINEERING DEPT. 259�8611 <br />24 HOURS 4EFORE CONSTRUCTION <br />CHECK LIST � <br />Water Valve <br />Drainage J <br />Curb & Guttei �� <br />Sidewalk � <br />� <br />-i: /'r' i <br />✓' �- , .,� �. _1�� <br />Inspector'sSignatwe �- <br />ate Z /G �� <br />j � i � 1 i i <br />,, �. <br />The undersigned owner hereby agrees to hold and <br />save harmless the City or Everett from any and all <br />claims for damages that may arise because of installa� <br />tion and maintenance ot the improvement hereto <br />applied for and further agrees m mmove same upon <br />notice (rom the City and m replace public properry <br />damagsd thereby. � . <br />Sionawre of�Applican[ <br />,. <br />Address <br />'-'-� ;.,c..: . . <br />Telephone Number_ � <br />- 7 L• <br />Dare <br />Fee <br />Dept. Approvals <br />Engineers____._._ <br />Water _ <br />Commu <br />PI <br />nnPro�ed n� <br />o.:,�� ��i�„���<<i � <br />