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APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br /> evcren <br /> e �1013 <br /> � CITY ENGINEFkS <br /> � EVERETT,WASHINGTON PERMIT N0. '�� ��'i �- <br /> �i The Undersigned '. �,�i i�r�: <br /> � Hereby applies for permir.ion to ���- r �- � i.i� � ' <br /> �I At the tollowing location `i .�.. � ' . <br /> SKETCH I� <br /> I (Work to be done) � <br /> �, ��/~." 1-i , �: �. � 1-. '- .> � <br /> I <br /> I <br /> I <br /> I <br /> � <br /> I <br /> I <br /> I <br /> I <br /> � <br /> I <br /> DRIVEWAY SECTION The undersigned owner hereby a�rees to hold and <br /> ' NO SCa�E save harmless thc City of Everett from any and al� <br /> . ��--- --� claims for damages that may arise because of installa� <br /> i ���� i�p � tion and maintenance of the improvement hereto <br /> � applied.tor and further agrees to remove same upon <br /> 30'�____._ ______ 30" notice irom the City and to replace public property �� <br /> � dam$getl thereby. • <br /> � . �= ,�; , _ .� � _ , <br /> �Signaturc of Applicant <br /> -- - - � ---- � . . � � - <br /> COPY OF THIS APPLICATION TO Address � , `-� , , , � <br /> BE POSTED ON J08SITE. " - - i -s -� .- <br /> �I CALL ENGWEERING DEPT. 259�OII71 TelephoneNumber' "� — <br /> I <br /> �2d HOUf;S f;EFOFG CONSTRUCI�ION Date <br /> , CHECK LIST Fee � ���� .-�t <br /> Water Valve Dept. ApproVals <br /> '� Drainage <br /> � Curb&Gutter Engineers � <br /> Sldewalk Water <br /> IStreet <br /> Communications <br /> Inspector's Signawre � <br /> Traffic <br /> Planninc� <br /> at-�--- — <br /> Remarks <br /> Note: Original to Customcr <br /> ,�ou� ,o F��� a.i n 7.3 <br /> . 1 Copl' to Inspec[or Appi...ed by <br /> Date Approved <br />