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W <br />CITY ENGINEERS <br />EVERETT, WASHINGTON <br />APPLICATION FOR RIGHT-OF-WAY USE PERMIT 11109 <br />PERPAIT N0. 7P 22 <br />The Undersigned C AI n 14 r 4 <br />Hereby applies for permission to_ et jr-,- SI/yF 1-,4 t/! _ Z! /' �'-{ <br />4- 'r/, Pxic7 n S/r _ <br />At the following location n G N l L is L A ,_ o A VC-- <br />(Work to be done) <br />DRIVEWAY SECTION <br />NO SCALE <br />I" LIP <br />COPY OF THIS APPLICATION TO <br />BE POSTED ON JOBSITE. <br />CALL ENGINEERING DEPT. 259 8811 <br />24 HOURS BEFORE CONSTRUCTION <br />CHECK LIST <br />Water Valve <br />Drainage <br />Curb & Gutter <br />Sidewalk <br />Inspector's Signature <br />Date <br />Remarks 11109 <br />The undersigned owner hereby agrees to hold and <br />save harmless the City of Everett from any and all <br />claims for damages that may arise because of installa- <br />tion and maintenance of the improvement hereto <br />applied for and further agrees to rer,nove same upon <br />notice from the City and to replace public property <br />damaged thereby. _ r, <br />Signature of Applicant <br />Address <br />Telephone Number <br />_5a 79';0 <br />Date <br />Fee iY l= <br />Dept' Approvals <br />Engineer's. <br />Communications <br />Apprevedby Pr—,, <br />j .fy <br />-.ti��} nnlALa:Y1.lC <br />Date Approved Y <br />FILE COPY 'lj=. �', ^ , � �-�� <br />