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. .... .. __ ... . ._:'r " . <br /> � APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br /> evcrclt <br /> � 10980 . � <br /> . .. , . ,- - - - � <br /> CITY ENGINEERS , ' <br /> EVERETT, WASHINGTON PERMITNO. �� �Q ` <br /> .-�� <br /> TAe Undersigned� / ��<S�/�' s,(�, � <br /> Hcreby applies}or permission to��,=�,�c.T A_�-��-��,'f/.F �,..1� j� / <br /> At the tollowing Ixation �( d f1�l.L �(. <br /> SKETCH <br /> (Work to be done) <br /> ' S;� �/}G/t�iJ . <br /> �. . � <br /> � <br /> - DRIVEWAY SECTION The undcrsiqned owner hereby agrees to hold and <br /> NO SCALE save harmless the City of EverMt from my and all <br /> � —'� - � claims for damag�:s that may arise because of installa• � <br /> p� ��p tion and ma�ntenance of the improvement hereto <br /> � � applied for and further agrecs to remeve same upon <br /> � �— � j--ry notice from [he City and to replace pu6lic property <br /> dama e thcryhy <br /> ' �' �� <br /> � ig/n ure of Applicant � <br /> 2�C a /`�fYi <br /> COPY OF THIS APPLICATION TO Addr¢ss <br /> BE POSTED ON JOBSITE. . .'� S2 • dt� �� <br /> CALL ENGINEERING DEPT. 259�0671 Teleph e Nu ber <br /> Q ` ! . <br /> 24 HOURS BEFOHE COP!STRUCTION Da <br /> CHECK LIST Fee <br /> Watar Valve � � � <br /> Oraina9e � Dept. Approval5 <br /> Curb&Gutrer - . Enqincers <br /> Sidewalk - � Water <br /> Street <br /> ' Communications <br /> locpectx'a SignaNro Traffic � <br /> � Planning , <br /> ate <br /> Ramarks <br /> Note: Original to Customer <br /> 1 Copy to File �O 9 8 O <br /> i Copy to Intpector Approvcd by ( <br /> n_� .�__.._. � <br />