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j <br /> everett APPLICATION POR RIGHT-OF-WqY USE PERMIT <br /> -.'_ p 11334 <br /> 6 <br /> CITY ENGINEERS �:3 i <br /> EVERETT, WASHINGTON PERMITNO.`f^ '= t� <br /> The Undersigned <br /> Hereby applies for permission to <br /> At the following location �''i� 7 :j �-'�'-i,• ., % f;F,-' , <br /> SKETCH __— <br /> (Work to be done) <br /> oeroEwar sec7i0N The undersigned owner hereby agrees to hold and <br /> � rv0 sca�E_ save harmless the City of Everett from any and all <br /> � -� claims for damages that may arise because of installa� <br /> I" Lla tion and maintenance of the improvement hereto <br /> I�30" I �30��� applied for and further agrees to remove same upon <br /> I -�� ----- notice from"the Ciry and [o replace public property <br /> damaged thereby: � , '.�. <br /> ,.`' �. . _. .. <br /> Signature of Applicant <br /> COPY OF THIS APPLICATION �f0 Address � <br /> BE POSTED ON JOBSITE. � � � <br /> CALL [IJGINEERING DEPT.259�8811 Telephone Number � <br /> ZA HOURS BEFORE CONSTRUCTION Date <br /> CHECK LiST Fee <br /> Water Valve <br /> Drainage Dept. Approvals <br /> Curb&Gutter Engineers <br /> Sidewalk <br /> Water <br /> , , �i5 �r-' <br /> i e i: �� " �' Street <br /> N `7 pr <br /> %C �� ��� Communications <br /> I r'sSignature �A•" . .— <br /> � Traffic <br /> � <br /> l �-(�(� 7 � �I I I�I 7 Planning <br /> ate <br /> Remarks <br /> 11334 - <br /> Approved by : �-�f i . � <br /> , �YI<l��' `,�/ <br /> I�SPECTOR'S COPY Date Approved .:.-��. , i --. - O <br /> . _�_ - r .�' <br />