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Ieveretl <br />�eJ � <br />CITY ENGINEERS <br />EVERETT,WASHINGTON <br />APPLICATION FrJR RIGHT-OF-WAY USE PERk11T <br />PERMIT N0. <br />The Urdc, ned ' .� �..i _ •� , � �.._ _ .l � - � <br />':y /> T-'n'' f� ni � � n <br />• �; � / � . �.... ' i <br />Hereby applies for permission to �� r, ��/C Td�uc 'T ia � � �a tpy� L— �/� <br />At the following location </ -� �/.�lh n/ �a _ _ � � <br />SKETCH i I <br />(Work to be done) <br />DRIYEWAY SECTION <br />NO SCALE <br />� -� <br />I" LIP <br />30" __ __ _ __ I 30�� <br />—�i' <br />COPY UF THIS APPLICATION TO i <br />BE PUST[D ON JOBSITE. <br />CALL [NGINEEP,ING DEPT. 259�8817 <br />24 IIOURS_ 9EFORE �OMSTRUCTION� <br />CHECK LIST <br />We.er Valve <br />Drainage <br />Curb & Gutter <br />Sidewalk <br />Inspector's Signature <br />Remarks <br />Note: Original to Customer <br />. 1CopytoFilc �(�(��� <br />1 Copy to Inspector <br />S s�C /'}' i I/�(- /i t �) <br />The undersigned owrer hereby agrees to hold and <br />save harmless the City of Everett from any and al� <br />ciaims (or damages'.hat may arise because of installa� <br />tion and maintcnan_e of the improvement herero <br />applied for and funher agrees to remove same upon <br />notice from t e Cit�' and to replac public property <br />damaged jher�by. �/%� � <br />�'f/ <br />Uate ,�. Z S� ! / j 7- <br />i ���Fee � � <br />Dept. Approvals <br />Engineers C� �1jl�rn�fr <br />Communications <br />Approved by <br />Date Approved <br />