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�Y���n <br />. • '� <br />CITY ENGINEERS <br />EVERETT. WASHIfvGTON <br />APP�ICATION FOR RIGHT-OF•WAY USE PERMIT <br />7-,,, <br />. . .L _ v L <br />PERMIT NO. � __ <br />The Under:igned � _ � � <br />Hereby appiies for permission to � «�r' 'r - '� � �' � � '� � ' '/- ` � � <br />f <br />At llie tollowing <br />SKETCH <br />(Work to be done) <br />. � . -. !-/; � i � <br />- �' fi':! .;c/� l',�{;�, <br />�'m,,.—.�...f.�'9 <br />� � .�_ <br />� <br />� <br />'+�~ ���.�. � <br />��l,f / /(7 � �l <br />DRIVEWAY SECTION <br />NO SCALE <br />� � <br />I" LIP <br />�30"� _ _ . _ _ I 30"� <br />_ , <br />COPY OF THIS APPLICATION TO <br />BE POSTED ON JOBS�TE. <br />CALI ENGINEERING DEPT. 259�8871 <br />24 HOURS BEFORE CONSTRUCTION <br />CHECK LIST <br />Water Valve <br />Drainage <br />Curb & Gutter <br />Sidewalk <br />Inspecl gnatu� <br />S- �9��e-7� <br />�-ate <br />arks <br />_�. �.. '� -� n <br />Ii:Si'CilOii'C �_.0'y <br />The undersigned owner h^_reby agrees ro hold and <br />save harmless the Ciry of Everetr irom any and all <br />claims tor dama9es that may arise because of installa� <br />tion .nd maintenance of the improvement hereto <br />appli?d for and further a9rees to remove same upon <br />notice from the City and to replace public property <br />damaged thereby. . � <br />Signature uf Applicant <br />� ���w( - <br />Address <br />. :�` � � � _ <br />Telephone Number �� <br />�-%rr _ <br />Date � <br />Dept. Approvais <br />En9ineers_ <br />Approved by <br />Date Approved � � '� <br />