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cperen , <br />� <br />CI fY ENGWEERS <br />EVFRETT, WASHINGTON <br />APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br />PERMIT <br />The l7ndersiyned �P r� ! .` �� � /� � i'�i ,ip N --_-----,---_ <br />Hereby applies tor permission ro i O/�/CY�'J :-,- r�) 7 1 ���,71ys'�„' '-. " y�r: <br />/ <br />At ihc tullowiny location ��_L[ _C C? c�_�_. �. �. � - ------ _--- <br />(Work to 6e done) <br />ORIVEWAY SECTION <br />NO SCALE <br />j-- _ Zs � — _ 'i <br />� —il'_LIP __—�� <br />'h30'� . _ �30"� <br />�COPY OF THIS APPLICATION TO <br />BE POSTED ON JOBSITE. <br />� CF�LL ENGINEEFING DEPT. 259�8811 <br />� 24 HOURS BEFORE CONSTRUCTION <br />CHECK LIST <br />Water Valve <br />Drainagc <br />Curb & Guttcr , <br />Sidewalk <br />Inspecior's Signature <br />Daic <br />licmarks <br />1.11.35 <br />CUfTOM[R <br />The undcrsic�ned owncn c�reby agrces m hold and <br />savc hannless ihe Ciry of Everett from any and all <br />claims for damages lhat may arise because of installa� <br />tion and maintenance of the improvement hereto <br />�pplied for and i•�rther agrees to remove same upon <br />notice fr the City and to replac�blic properry <br />dnma thereby. � <br />�i <br />���LC�C.� _ �-�--` <br />5in �ew� oF Apnlicac� ,ri. _ ,� i ., <br />aJifress � � �ril:,a��l�$ <br />��' ��/lsc �; ��,. -, <br />T I �'� Numbcr --- L , <br />L, �- �� �% »� <br />Datc <br />Fec j-) .—�..------ -- <br />Dept. Approvals <br />En9inecrs _ <br />Watcr--- -- <br />SUcet <br />Convnunications <br />Tra((ic _ <br />Planninc�_ <br />Approved by <br />Date Approved � <br />