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gveren . „ „ <br />� � <br />CITY ENGINEERS <br />EVERETT, WF.SHI�GTON <br />APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />PERMIT <br />TheUndersigned �' " - ,��./ <br />Hereby applies for pertnission to ' - - . -• �' _ – i\ �, . <br />At the following location •� S'i // �" r^ r= r-, ,-,. �L f� <br />(Work to be done) <br />ORIVEWAY SELTION <br />NO SCALE <br />�--- . . � -- _ . _ _ -`� <br />I" LIP <br />�30'y _ . _ . _ . w30"�I <br />� <br />COPY OF THIS APPLICATION l�0 <br />Bt ?OSTED ON JOBSITE. <br />CALL ENGINEER�NG DEPT. 259�8811 <br />24 HOURS BEFORE CONSTRUCTION <br />CHECK LIST <br />Water Valve <br />Drainage <br />Cur6 & Gutrer <br />Sidewalk <br />� <br />� <br />�i�.�.�(��/ ��_,�-'� i. _ — <br />I nspector's Signature <br />-1% <br />—6ate <br />' <br />Remarks <br />.�. � .L ,^' C <br />r <br />11135 �'' <br />un �:�. _ —. <br />The undersigned owner hereby agrees to hold and <br />save harmless the City of Everett trom any and all <br />claims for damages that may arise because of installa� <br />tion and maintenance of the improvement hereto <br />applied for and further agrees to remove same upon <br />notice from the Ciry and to replace public property <br />damaged thereby. <br />Signature of Applicant <br />Add,ess <br />Telephone Number � <br />Dept. Approvals <br />Water <br />Ccmmunications <br />� <br />Traftic <br />Approved by <br />It�SPECTOI��t: COP, Date Approved <br />0 <br />