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l <br />�vereY� <br />� <br />CITY GINEERS <br />EVERETT, WASHINGTON <br />APPLICATION FOR RIGHT-OF•WAY USE PERMIT � 12 61 <br />,r � - <br />� 7 <br />PEHMIT N0. / �� J <br />The Undersigned _ � � ' � � �" � � . _ <br />Here6yappliesforpermissionto � � _ � ������� � ' �'• �� �� � '-� ' u."�, <br />� �- <br />.._ <br />At the following location_ . ��� � .. � ' . . `. ' " ;�r�2::'`R�-� :� <br />— , — <br />i._�.' _. �c' 1�l ., <br />(Work to be done) <br />,�7�f�'iil�lC C�:�t <br />������ <br />�����,4�r.-�..,� Y <br />, �r•; - �, � <br />., <br />iI / ' <br />DRIVEWAY SECTION <br />NO SCALE <br />�' LI S � �.f.i....7-,C, <br />��.�� - __�30„ <br />, �=r__ <br />CUPY 0' .:IS APPLICATION TO <br />BE POSTED ON JOBSITE. <br />CALL ENGINEERING DEPT. 259�8811 <br />24 FiOURS BEFORE CONSTRUCTION <br />���t�� -79 <br />ate <br />� <br />� <br />Y <br />� <br />a" <br />� <br />�� The undersigned owner hereby agrees to hold and <br />� save hartnless the CitV of Everett from any and all <br />ciaims for damages that may arise becauu of installa• <br />tion and maintenance of the improvement hereto <br />applied for and furffier agrees.to remoVe same upon � <br />notice from the Ciry and to replace publfe property � <br />damaged thereby.. � � ' �'; , � <br />, t <br />�� ; �. ' <br />Signature of Applicant y , <br />r ���1�'l .� ��-� �:�f � <br />Address � ' � � � � � <br />. .. Y; :� . . . . <br />Telephone Number ; � ' � <br />, , - ( <br />Date � � / �- ' <br />Remarks <br />11261 <br />Dept. Approvals <br />Approved by L.% . . . <br />, - r �i ��.i, !1~I :l ^� / <br />Date Approved -� � .; ���� � <br />INSFECTOR'S COPY � � " . �. ' <br />