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I A <br />everetl � <br />. � -e <br />' CITY ENGINEERS <br />� EVERETT, WASHINGTON <br />APPLICATION FOR RIGHT-OF-WAY USE PERMIT 1114 9 <br />PERMIT N0. �1 `� � � <br />The Undersigned _ t�C� --�- � �� n/�-✓ � �—"S <br />Hereby applies for permission to _. tiL S�-s/ / /_?.: � ii� .^,v f=?' y-- l'i-,,:_,�� ,�.1. � i <br />/>>r<,_ ,..,T .. <br />AtthefollowingloCation_ �C� f`' l��ni�� rf��rnF ';y'. <br />(Work to be done� <br />�-- �.� I - <br />'--' I'-------- ' � ------ <br />� <br />� <br />ORIVEWAY SECTION <br />NO SCALE <br />� � <br />I" LIP <br />�_30�_. _. ..___ _.. . . -.�'3�7 <br />i , <br />COPY OF THIS APPLICATION TO <br />BE ?OSTED ON JOBSITE. <br />CALI ENGINEER�NG DEPT. 259�8811 <br />24 HOURS 6EFORE CONSTRUCTION <br />CHECK UST <br />Water Valve <br />Drainage <br />Curb & Gutter <br />Sidewalk <br />Inspector's Signamre <br />Remark: <br />��.�.��-;1 <br />I�:SPI[Ci0i2'� COPY <br />z <br />f'�/'GK ��/G <br />��s�'r s��.�i-- <br />The undcrsigned 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 improvemen[ hereto <br />applied (or and turther agrees to remove same upon <br />notice from die City and to replace public property <br />damaged thereby. <br />Signawre of Applicant <br />/-. <br />Address <br />Telephone Number <br />Date <br />Dept. Approvals <br />Ccmmunications <br />PI <br />Approved by <br />Datc Approved 3 <br />