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evenrtt <br />CITY ENGINEEi. <br />EVERETT.WASHINGTON <br />The Undersigned <br />Hereby applies for permission to <br />At the <br />(Work to be done) <br />'r::D I ,p/ji% <br />APPLICATION FOR RIGHT-OF-WAY USE PERMIT j j 26 2 <br />7Y1 (Q/ <br />PERMITNO. N4 <br />t <br />%'IOSlr��vP(�G,ttJicr,� �l-�2� <br />i <br />Le -Tr 461 <br />DRIVEWAY SECTION <br />NO SCALE Cke,le 48• ra+fr4,a� <br />—ovtLn6 <br />�•ti•tY <br />II" LIP <br />30" 1 <br />COPY OF THIS APPLICATION TO <br />BE POSTED ON JOSSITE i <br />CALL ENGINEERING DEPT.259-BBI1 <br />24 HOURS BEFORE CONSTRUCTION <br />CHECK LIST <br />Wabr Valve <br />Drainage <br />Curb & utter <br />Sidewalk <br />Inspector's Signature <br />Date <br />Remarks 11262 <br />r'�ll <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 installa• <br />tion and m.*ntenance of the improvement hereto <br />applied f�nd further agrees to r love same upon <br />notice fr tb4ity and zrenW'1irblic1nrnn•rw <br />Telephone Nu ,ber� <br />Date <br />Dept. Approvals <br />Water <br />Communications <br />Traffic <br />Planning <br />Approved by <br />CUSTOM= Date Approved 0 <br />