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wAPPLICATION FOR RIGHT-OF-WAY USE PERMIT 11262 <br />CITY ENGINEERS )j <br />EVERETT. WASHINGTON PERMITNO / Cfr <br />The Undersigned _— ' - ! - <br />Hereby applies for permiuion'e `'rs l^ al-'e 1/T— ' 1 <br />At the following location - L !'''T Ala" � L, 1/� 1_I fV L:, <br />t^s <br />(Work to be done) ��.-�•�� <br />IV 11ly44Ljerj" , <br />ill 4wP l c +� I <br />it <br />( <br />II <br />t <br />DRIVEWAY SECTION <br />NO SCALE <br /># I" LIP <br />COPY OF THIS APPLICATION TO <br />BE POSTED ON JOBSITE. <br />CALL ENGINEERING DEPT. 259 $811 <br />24 HOURS BEFORE CONSTRUCTION <br />CHECK LIST <br />Water Valve <br />Drainage <br />Curb 6 Gutter <br />Sidewalk <br />Ins{ 's Signature <br />ate <br />lye. <br />The undersigned 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 insialla- <br />Lion and maintenam.e of the improvement hereto <br />applied for and further agrees to remove same upon <br />notice from the City and to replace public property <br />damaged thereby. <br />Signature of Applicant <br />Address <br />Telephone Number <br />Date <br />Fee <br />Dept. Approvals <br />Eng.neers_ <br />4'D Communications <br />)�7 Y Traffic <br />10'15d Planm ig. <br />Remarks <br />11262 <br />Approved by <br />INSPECTOR'S COPY Date Approved <br />