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�1 <br />evn-^� <br />.� <br />CITY ENGINEERS <br />EVERETT, WASHINGTON <br />The Undersigned � <br />APPLICATION FOR RIGHT•OF-WAY USE PEa.nni'( <br />10973 <br />� <br />PERMIT N0. � Z� Z <br />_ j � _ � <br />Hereby applies for pertnission to ,`�?ni S t�(�,iG i A /� GR� yr � 1�,/ �Ss-.,,� �✓,� k i_ <br />,;.�Z-.,s> <br />At the following towtion. 4• 3 0�i __ �,r.6- �i p �k t�= __ ___ <br />(Work to be done) <br />DRIVEWAY SECTION <br />NO SCALE <br />� � <br />�— � f' LIP <br />���1•____—.___.— ___—'1'30�'1 <br />.. ___ . _..____..__ __. <br />rCOPY OF Ti IIS 11PPUCl�TION TO � <br />BE PUSTED ON .IOQSITE. <br />CALL [NGINEERING DEPT. 259�8817 <br />2d HOUP.; �6FORE CONSTftUCTIONI <br />CHECK LIST <br />Water Valve <br />prainage <br />Curb & Gutrer <br />Sidewalk <br />Inspecmr's SignaWre <br />Remarks <br />Note: Original to Customer <br />1 Copy to File 10973 <br />1 Copy to Inspector <br />SCC RiRcri�v <br />The un,lersigned ownen c�reby agrees to hold and <br />save harmless the City ot Everett from any and all <br />claims for amages that may arise because of installa- <br />tion and m intenance of the improvement hereto <br />applied fo and further agrees to r ov ame upon <br />noticyffo the City and re� ic properry <br />uace ,�rZ S� <br />Fee <br />Dept. App� vals <br />Engineers� �� ��(i-Jti(^ <br />Water <br />Plann <br />Approved by <br />Datc Annroved <br />