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everett <br />.• <br />CITY ENGINEERS <br />EVERETT, WqSHINGTON <br />The Undersigned <br />Hereby applies for permission to <br />APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />.i_ ; <br />.�+ the following location l � I �J �': �• ,_. � ..� ��r <br />11191 <br />PERMITNO. ��f" � � <br />(Work to be done) f'„ _. l/•. i, "- ` .. '. <br />. . . .J l / !C. � .. .., i. ... i <br />DRIVEWAY SECTION <br />NO SCALE <br />�-- --- - ---� <br />� I" LIP —��� <br />30'.L__ � _.. _ _ _ _ . . ____.1.30" I <br />� �t <br />COPY OF THIS APPLICATION TO J�� <br />BE POSTED ON JOBSITE. �� <br />CALI ENGINEERING DEPT. 259�8871 <br />24 HOURS BEFORE CONSTRUCTION en,� <br />CHECK LIST �\ ��� <br />Water Valve , V <br />Drainage ' U <br />Curb g Gutter �� ,1 � <br />Sidewalk , \�i �v <br />I nspec[or's Signatum 4 <br />�ate <br />Remarks <br />The undersigned owner hereby agrees to hoid and <br />save harmless the City of Evr.rett from any and all <br />claims for damayes that may arise because of installa� <br />tion and maintenance of the improvement hereto <br />applied for and further agrees to remove same upon <br />notice from the City and ro replace public properry <br />damaged thereby. <br />Si9nature of Applicant <br />Address <br />Telephone Number <br />Date <br />Com <br />Plann <br />Approved by <br />INSPECTOR'S COPY" pate Approved <br />Dept. Approvals <br />