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• ' '"� APPLICATION FOR RIGHT-OF-WAY USE PERMIT ��� 6 ,z <br /> everetl <br /> � <br /> _CITY ENGINEERS pERMII'N0. � '"' — %�� � <br /> EVERETT,WASHINGTON <br /> / � �_� � <br /> The Undersigned � -� `� � `�� � � � <br /> ' � � �.I.-rYr._l, ^ /:7 . <br /> Hereby applies for permission to �� , __ <br /> At the following location ��� � -� ~ f��� � ���� /�/ <br /> ./ <br /> SKETCH <br /> (Work io be done) <br /> � <br /> i ->r� J�� !1 '� <br /> i ., �� <br /> � .. <br /> DRIVEWAY SECTIJV The undersigned owner hereby agrees to hold and <br /> NQ SCaLE' save harmless the City of Everett from any and all <br /> � � claims for damages that may arisc because of installa� <br /> tion and maintenance of the improvement hereto <br /> t'�LiP � applied tor and further agrees to remove same upo� <br /> 30" n6ti e from the CIt'y q d to replace public property <br /> 30" — d2�a9ed thqFe¢Y.%i�i 1-� ; <br /> r <br /> � r /� � � � .� sl.✓' <br /> � pp ib2h ' <br /> I r �'ti <br /> Addre'ss r` � � � <br /> COPY OF THIS APPLICATION TO � , - �I • <br /> BE?OSTt:DONJOBSITE. TelephoneNumber 1 <br /> 5ss"2,c..•-c- � �� ; <br /> CALL ENGitJEERING DEPT. 259-8811 Date /T r! <br /> ��,.� � 24 HOURS BEFORE CONSI"RUCTION <br /> • � -- Fee'; � -. <br /> CHECK LIST - _ . � � pept. Approvals <br /> Water Valve � � � - <br /> Drainage Engineers , <br /> Curb&Gutter yya�er_ <br /> Sidewalk <br /> /"' ' / Street <br /> �� � i ' <br /> r ( ;' �'� Communications <br /> Inspector's SignamrE Traffic <br /> 7 // Planning <br /> �� / � �J Y / <br /> ate <br /> �/l � � � - <br /> Remarks <br /> 11.162 _ <br /> Approved by � . � <br /> p <br /> Da[e Approved � � <br /> � INSPECTOR'S COPY ' -� <br />