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APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />11340 <br />CITY ENGINEERS <br />EVERETT.WASHINGTON <br />The Undersigned 0%L7)LP///!✓ !f-eee"I, S <br />Hereby applies for permission to _ -7 to /� /I <br />PERMIT N0. 76 —243 <br />n ' <br />At the following location —cTrr -� -..' - 3 Sd, rMrrcl �UP <br />-L6 <br />(Work to be done) <br />DP.IVEWAY SECTION <br />NO SCALE <br />I" LIP <br />_30 <br />JPY OF THIS APPLICATION TO <br />BE POSTED ON JOBSITE. <br />CALL ENGINEERING DEPT. 259.881 t <br />I?.t HOURS BEFORE CONSTRUCTION <br />CHECK LIST <br />Water Valve <br />Drainage <br />Curb & Gutter <br />Sidewalk <br />Inspector's Signature <br />Remarks <br />,NJ <br />91� <br />The undersigned owner hereby agrees to hold and <br />save harmless the City of Everett from any and all <br />aims for damages that arise because of installa- <br />tI and mainten of the improvement hereto <br />ap li for further agrees to remove same upon <br />ryo is om the City and to replace public property <br />Jdj -- L <br />L- + f.r% .L .4/%7- / v <br />.--- %, ci U <br />Telephone Number <br />703 <br />Date CL <br />Fee —57ef/ <br />Dept. Approvals <br />Engineers <br />Water______ <br />Street -- <br />Communications -- <br />Traffic <br />Piannina <br />Approved by <br />CUSTOM" Date Approved <br />