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APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />everett <br />CITY ENGINEERS <br />EVERETT,WASHINGTON <br />The Undersigned u n IF f <br />Hereby applies for permission to <br />At the following location 4 d01 L Y U N t Ul UO & 'U K. <br />NORTI4 LIPPER PORT 1 Dal Jf LOT 2Gt <br />(Work to be done) <br />EXISTING Z DWf Of <br />PAVE MFV r <br />16, X60 seu)eg <br />ER_SEMF-VT _ <br />New .SAS;' 1. <br />tbd <br />0 <br />A <br />en <br />w <br />D.'IVEWAY SECTION <br />NO SCALE <br />' — <br />--{ <br />f --- 21 <br />I' LIP <br />-4901 <br />INIMUM I-Qe DRAW <br />CUL VeR7- <br />Wi <br />COPY OF THIS APPLICATION TO N. 131 L. AA <br />7 <br />BE POSTED ON JOBSITE. ' 4 — 75 <br />CALL ENGINEERING DEPT. 259-8811 <br />24 HOURS BEFORE CONSTRUCTION <br />CHECK LIST <br />Water Valve <br />Drainage <br />Curb & Gutter <br />i <br />Sidewalk <br />Inspector's Signature <br />Remarks <br />Note: Original to Customer <br />1 Copy to File 10240 <br />1 Copy to Inspector <br />4��t; <br />10240 <br />PERMIT NO. , ✓ 6� <br />NO SCALL <br />The undersigned owner hereby agrees to hold and <br />save harmless the City of Everett from any and all <br />claims for damages 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 />not# I from the City and to replace public property <br />d aged thereby. <br />Signature of Applicant <br />Address <br />Telephone Number <br />Date O <br />Fee <br />Engineers <br />V�L,� <br />%Ir 7,f <br />Water <br />Street <br />Commun#cati <br />Traffic <br />5�9-- "-�' <br />��- 7S <br />Planning <br />7 <br />AppMy/lam •jibsyCL,-I,Cit.J d 7S <br />Date Approved <br />