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APPLICATION FOR RIGHT-OF-WAY USE PERMIT 1 0585 <br />everett 1 ' <br />CITY ENGINEERS PERMIT NO. 7 <br />EVERETT,WASHINGTON '\ <br />I <br />The Undersigned <br />in <br />B o <br />Hereby applies for permission to <br />D D StjivL0 1 /.�.� ✓O vYl <br />S I <br />At the following location L 1? i AA II <br />SKETCH <br />(Work to be done) <br />^ }w <br />4+rY pair <br />3121 fll <br />Sa rae'- <br />/L <br />oa she». <br />I TAQ <br />io 6a sIAI(J%a/ rS <br />CInAuIJ,e,t ,/r.� L <br />1 `b v <br />\ (1 t <br />--7 \, <br />/b The undersigned owner hereby agreas to hold and <br />DRIVEWAY SECTION save harmless the City of Everett from any and all <br />NO SCALE _� 9-eleims for damages that may arise because of installa. <br />------- tion and maintenance of the improvement heretoi <br />I" LIP �- applied for and further agree <br />sto remove same upon <br />+ <br />so" --__ <br />I �..30'� � "�?� notice from the City and to replace public property <br />damaged thereby. <br />Signature of Applicant <br />Address <br />F <br />PY OF THIS APPLICATION TO <br />POSTED ON JOBSITE. TelephoneNuliber <br />LL ENGINEERING DEPT.259-8811 Date <br />24 HOURS BEFORE CONSTRUCTION e <br />\\�`vJ►� <br />� �GJ Fee De , <br />CHECK LIST pt, A pro als <br />I Water Valve <br />Drainage Engineers <br />Curb &Gutter Water U <br />Sidewalk <br />1 Street <br />Communications <br />Inspector's Signature Traffic <br />Planning �Q--- <br />ate III <br />Remarks <br />Note: Original to Customer 10585 I <br />' 1 Copy to FileApproved by <br />1 Copy to Inspector <br />Date Approved ' <br />