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� APPLICATION FOR RIGHT-OF-WAY USE PERh71T <br />evrre•'t <br /><<� <br />10723 <br />�� <br />CITY E?lGIPlEERS c/ <br />E'✓ERETT,�VASHINGTON. PERMITNO.� c3 � <br />The Undersigned _ n/-� �i t n � � � ���� i ,� . • <br />Here6y apPlirs ;or permission to r n r/ ^ yTu r`> > 7 O r� j.^ .�: ,-- i�. <br />i <br />Atthelollowinglocation_%,<:D i L�r��,rr -_ln� <br />�4Vork to tr_ done) <br />DRIVEWAY SECTION <br />, NO SCALE J <br />i«--_— — I <br />1" llP 1 <br />�.OJ+"__"'._.._ ��"'J� <br />i <br />COPY OF THIS APPLICATION TO <br />BE POSTED ON JOBSITE. <br />CALI ENGIfJEERING D[PT. 259�8871 <br />24 HOURS [iEFORE CONSTRUCTION <br />CHFCK LfST <br />Water Vaive <br />Drainage <br />Curb F� Guttcr <br />SidewaL'< <br />Inspectar'; Signature <br />–�e <br />FI _ m:�rks <br />f lntc: Ori9inal to Cusromer <br />1 Copy to File 10 7 2 3 <br />1 Copy to Inspe[ror <br />,•� _.i r� ;.s/.i.� � <br />����� %% The undersigned owner hereby agrees to hold and <br />save harmless the Ciry of Everett f`rom any and all <br />�$5- � claims for d�mages that may arise Gecause of instalia- <br />!v tion and maintenance of the improvement hereto <br />applied for and further a9rees to remove same upon <br />poUce from the Cijy;an�to replace puplic properry <br />ayamayed thereby,./ f/ � l � ``i <br />L: �it.� ✓�/ _+. �.. __–__ <br />U �� .-�.: ( n <br />' ..'i - �7er <br />o ; <br />Tciephone Number <br />� �7�j?7 <br />Date � <br />/� � �-�' ������- <br />Fee <br />Dept. Apprnvais <br />Engineers <br />Water_ <br />Sdt^'-- <br />Communica!ions <br />Trelfic � <br />APProved by <br />_.'----- - �,_.Date Aoernved - - <br />� <br />� <br />