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• (werett , <br /> APPLICATION FOR RIGHT-OF-WAY USE PERMIT 1119 5 <br /> � � - e <br /> CITY ENGINEEFS <br /> EVERETT,WASHiNGTON PERMITNO.J��'�" � Z � <br /> TheUndersigned �� -C 1 ��� .-I I-i�.},;� �.-'i <br /> � <br /> Herebyappliesforpermissionto � .-�� ' -�� - % = I) � <br /> At the following location � P'� i - � .� <br /> SKETCH <br /> (Work to be dane) <br /> DRIVEWAY SECTtON The undersigned owner hereby agrees to hold and <br /> NO SCaLE save harmless the City of Evere:t from any and all . <br /> �— ., � claims for damages that may arise because of installa• <br /> i" LiP tion and maintenance of the improvement here[o <br /> applied for and further agrees to remove same upon <br /> �30'�. ,_r__,___�30" notice from the Ciry and [o replace public property <br /> �' damaged thereby;� �->' . � �� � . <br /> . <br /> ' ( (/ iF- i: % <br /> Signature of Applicant ' <br /> � . <br /> � , ' 1' `1.1>>/f � <br /> COPY OF THIS A?PUCATION TO Address , <br /> BE POSTED ON JOBSITE. �� '`��� %�s �� � � � <br /> � Teleph�one Number <br /> CALL ENGINEERING DEPT. 259�8811 ...�/ �/ _ ij!' � <br /> 24 HOURS BEFORE CONSTRUCTIOiV Date � <br /> CHECK LIST Fee `� ; _ <br /> Water Valve Dept. ApproVels � <br /> Drainage <br /> Curb &Gutrer Engineers , <br /> Sidewalk Water � <br /> Street <br /> Communications . <br /> Inspecto Signature Traffic <br /> �— �'�� <j Planning <br /> S r�� 1 <br /> at�� <br /> Remarks <br /> �1� 95 �` <br /> Approved by :��'�' .._i'. . _( -7-�_ <br /> � � ''/( ';tr� I\I ���1 �'7/-- <br /> � Date Approved � ��� / � <br /> . INSPECTOR'S COPY -- �i <br /> � J <br /> �. <br />