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APPLICATION FOR RIGHT•OF•WAY USE PERMIT <br /> ev� <br /> 1-0755 <br /> � CITY ENGINEERS �� <br /> �� EVERETT,WASHINGTON PERMIT NO. � �� U� li <br /> � The Undersigned_ '/ � � '� �� � .:�� � ; . ' I <br /> �. Hereby applies for permission m ' - : ,� �� � �' �l °:,°�• i i ' Ij/ � i <br /> ( <br /> . At the following location � � /��_-.1 i�- " ��� .� 1 : <br /> � <br /> SKETCH �'�'. <br /> i (Work to be done) �� <br /> ' `� _'� �-r� i�����-/,'',j I <br /> I i <br /> � <br /> I <br /> ii �� <br /> ' i <br /> ; � <br /> � � <br /> , • j <br /> ; <br /> I <br /> I ' I <br /> i I <br /> � <br /> I <br /> � ' <br /> i � <br /> ��� DRIVEWAY SEC710N The undersigned owner hereby agrees to hold and ! <br /> . NO SCALE save harmless Ihe City of Evcrett from any and all <br /> �� �-- -� claims for damages that may arise because of installa• ; <br /> f' LIP tion and maintenance ot the improvement hereto . <br /> � applied for and further agrees to remove same upon <br /> �i 30" _ __�30" notice from the Ciry and to replace public property � <br /> I damaged thereby. ' <br /> �� ..� , . ..�,•r ' <br /> '. Signature of qpplicant " i <br /> ! COPY OF THIS APPLICA.TION TO Address 'i <br /> ' BE POSTED ON JOBSITE. - � � I <br /> � Telephone Number �' <br /> i CALL ENGINEERING D[PT. 259�8811 _ , ' <br /> ', 34 HOURS �E�OR[ CONSTRUCIIOW� Date <br /> �----- <br /> � , ..- j,'r , <br /> 'i CHECK LIST �Fee ' '- . <br /> ! Water Valve Dept. Approvals <br /> �, Drainage � � �� <br /> ��� Curb&Gu[[er Engineers �' <br /> I Sidewalk . � Water_ .. � � 'i <br /> i, � ., _ S[reet � � -. � �, <br /> � Communications � <br /> Inspector's Signature Traffic '' <br /> , Planning ' <br /> �' ate - . � . � i <br /> Remarks <br /> Note: Original to Customer ' <br /> , ��PY ������ 10 7 S 5 I <br /> 1 Copy to Inspector Approved by ' <br /> Datc Approved <br />