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W <br />CITY ENGINEERS <br />EVERETT,WASHINGTON <br />The Undersigned <br />Hereby applies fo <br />APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />At the following location_ <br />(Work to be done) <br />y6a <br />st=c A;j,a�hrr� <br />DRIVEWAY SECTION <br />NO SCALE <br />LIP <br />COPY OF THIS APPLICATION TO <br />BE POSTED ON JOBSITE, <br />CALL ENGINEERING DEPT. 259.8811 <br />24 HOURS BEFORE CONSTRUCTION <br />CHECK LIST <br />Water Valve <br />Drainage <br />Curb & Gutter <br />Sidewalk <br />Inspector's Signature <br />i <br />ate <br />Note: Original to Customer <br />1 Copy to File 11078 <br />1 Copy to Inspector <br />11078 <br />PERMIT N0. <br />The undersigned owner hereby agrees to hold and <br />save harmless the City of Everett from any and all <br />claims for damages thit may arise because of installa— <br />tion and maintenance of the improvement hereto <br />applied for and f rther agrees to remove same upon <br />notice from th ' ity and replace public property <br />damaged I • eby/ <br />SigngtUre of Applicant <br />Address <br />1473, <br />Telephone Number <br />Date <br />Few— <br />nDept. Approvals <br />Engineers !/(J���!/('/��� <br />Commun <br />Planning <br />Approved by <br />Date Approved <br />11 <br />